Frailty phenotype and the role of levodopa challenge test in geriatric inpatients with mild parkinsonian signs.

Deficiency in dopaminergic system function may be one of the hypothetical reasons of the frailty syndrome but its role still remains unclear. The aim of our study was to assess the frailty phenotype prevalence in geriatric inpatients with mild parkinsonian signs (MPS) and to investigate levodopa test in the frail patients with MPS. We examined 118 participants: 90 with MPS and 28 in control group (without MPS). The frailty syndrome presence was evaluated by the Fried criteria. Deficiency in dopaminergic system function was assessed by one of the modifications of an acute levodopa challenge test (LCT): in MPS group every patient was examined by performing Up and Go Test and also Step Test before and 3 h after taking 125 mg of Madopar (levodopa + benserazide). Sixty-nine study subjects (58%) met criteria for frailty. Fifty-five participants in MPS group (61.1% of MPS group) and fourteen (50%) in control group. All of the patients that scored positive in walk speed criterion of frailty were frail. When all MPS patients were considered, the number of components scored positive for frailty was directly related to the walk speed (r = -0.70, p < 0.0001). In MPS group LCT scores were significantly higher for frailty patients compared to non-frailty (p = 0.0027). When all MPS patients were considered, the number of components scored positive for frailty was directly related LCT score (r = 0.37, p = 0.0004). There was a relationship between LCT and walk speed (r = -0.31, p = 0.0032). Our observations provide new information about the relationship between frailty and MPS, suggest the need for increased awareness of frailty in MPS patients and conversely. Our study provides data for a discussion on pathophysiological background of the frailty syndrome (FS), emphasizing the theories of the important impact of dopaminergic system deficit and encourages further research on the role of LCT in measuring it.

Tumor Necrosis Factor-Related Apoptosis-Inducing Ligand-Induced Apoptosis in Prostate Cancer Cells after Treatment with Xanthohumol-A Natural Compound Present in Humulus lupulus L.

TRAIL (tumor necrosis factor-related apoptosis-inducing ligand) is an endogenous ligand, which plays role in immune surveillance and anti-tumor immunity. It has ability to selectively kill tumor cells showing no toxicity to normal cells. We tested the apoptotic and cytotoxic activities of xanthohumol, a prenylated chalcone found in Humulus lupulus on androgen-sensitive human prostate adenocarcinoma cells (LNCaP) in combination with TRAIL. Cytotoxicity was measured by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide tetrazolium reduction assay (MTT) and lactate dehydrogenase assay (LDH). The expression of death receptors (DR4/TRAIL-R1 and DR5/TRAIL-R2) and apoptosis were detected using flow cytometry. We examined mitochondrial membrane potential (ΔΨm) by DePsipher reagent using fluorescence microscopy. The intracellular expression of proteins was evaluated by Western blotting. Our study showed that xanthohumol enhanced cytotoxic and apoptotic effects of TRAIL. The tested compounds activated caspases-3, -8, -9, Bid, and increased the expression of Bax. They also decreased expression of Bcl-xL and decreased mitochondrial membrane potential, while the expression of death receptors was not changed. The findings suggest that xanthohumol is a compound of potential use in chemoprevention of prostate cancer due to its sensitization of cancer cells to TRAIL-mediated apoptosis.

Dermoscopy of halo nevus in own observation.

INTRODUCTION: Halo nevus (HN) is a rare dermatologic entity characterized by a typical whitish rim encircling the existing melanocytic nevus resembling a halo. The clinical picture is suggesting its diagnosis, but so far only several dermoscopic descriptions of halo nevus have existed in the PubMed database. AIM: To present the clinical and dermoscopic characteristics of halo nevus observed in dermoscopy. MATERIAL AND METHODS: Fifteen patients were diagnosed clinically and dermoscopically with halo nevus during planned routine dermoscopic examinations of all melanocytic lesions in 2007-2013. All digital images stored in the computer database were analyzed retrospectively according to the procedure described in the study. The clinical and dermoscopic parameters such as the dermoscopic pattern, color of nevus, special features and description of the surrounding halo were analyzed statistically. RESULTS: We analyzed 22 halo nevi (9 in females, 13 in males) in 15 patients (7 females, 8 males) diagnosed during the dermoscopic examination. The mean age of patients during dermoscopic examinations was 18.2 years. Mean patients' age at HN onset was 15.7 years. Halo nevi occurred the most often as a solitary lesion. The ratio of multiple halo nevi to solitary halo nevus was 5 : 10. Every third halo nevus was located on the posterior trunk upper. In 68.2% of HN cases, the surrounding rim (halo) was characterized by its homogenous, whitish color. CONCLUSIONS: Dermoscopic patterns such as uniform globular and structureless constituted one-third each of them in all analyzed patterns.

Dermoscopy of accessory nipples in authors' own study.

INTRODUCTION: The accessory nipple (AN) is characterised by its network-like structures, which may suggest the diagnosis of a melanocytic lesion. The knowledge about additional dermoscopic features of AN may greatly minimise the risk of unnecessary surgical excisions. AIM: To analyse and present different clinical and dermoscopic forms, in which the AN may appear. MATERIAL AND METHODS: Ninety AN with dermoscopic features were evaluated in the study, detected in 14 patients between the years 2008 and 2014. RESULTS: The most common dermoscopic features of the AN were central, scar-like areas (15/19) and peripheral network-like structures (12/19). A number of cleft-like appearances (8/19) and central network-like structures (7/19) had also been observed. Moreover, among the dermoscopic features, white cobblestone-like structures (7/19), a central round dimpling with a plug (6/19) and fisheye-like structures resembling comedo-like openings (9/19) have all also been noted. There is a statistical significance in the occurrence of white cobblestone-like structures with central network-like structures (Fisher's exact test p = 0.0449). The presence of peripheral network-like structures with the occurrence of central scar-like areas was statistically highly significant (p = 0.0091). The central round dimpling was never observed alongside any central network-like structures in any of the lesions (p = 0.0436). CONCLUSIONS: Accessory nipples are most commonly characterised by the occurrence of a peripheral network-like structure accompanied by the presence of a scar-like area.

Inferior performance on selected neuropsychological tests in abstinent schizophrenia patients who have used cannabis.

BACKGROUND: A substantial proportion of patients with schizophrenia have co-morbid psychoactive substance use, which can influence their cognitive functions. The aim of this study was to assess cognitive functioning in abstinent schizophrenia patients with various previous patterns of psychoactive substance use. MATERIAL/METHODS: The study was performed on a group of 80 schizophrenia patients (74 men, 6 women), aged 18-40 (mean 25) years, of whom in 40 a co-morbid psychoactive substance abuse was diagnosed. The latter group was subdivided, based on their predominant type of substance (opioid, amphetamine, or cannabis). All patients were examined during clinical improvement, and patients with comorbid substance use were also examined after a 6-week period of detoxification in a therapeutic community. A battery of neuropsychiatric tests was used, which included subtests of Trail Making test, Stroop test and Verbal Fluency test. RESULTS: No significant differences in clinical factors and cognitive functioning between the 2 examined groups were found. However, when the patients were divided according to their pattern of substance use, it turned out that the group of patients who used cannabis, despite the shortest duration of disease and that of addiction, and highest percentage of using atypical antipsychotics, performed worse on all cognitive tests, significantly so on Stroop and Fluency tests, compared to the groups with predominant opioid or amphetamine use. CONCLUSIONS: Abstinent schizophrenic patients who previously used cannabis have worse cognitive functioning compared to other schizophrenic patients with comorbid substance use. The possible role of previous cannabis use or cannabis withdrawal in this phenomenon is discussed.

Characteristics of Al-Si Alloys with High Melting Point Elements for High Pressure Die Casting.

This paper is devoted to the possibility of increasing the mechanical properties (tensile strength, yield strength, elongation and hardness) of high pressure die casting (HPDC) hypoeutectic Al-Si alloys by high melting point elements: chromium, molybdenum, vanadium and tungsten. EN AC-46000 alloy was used as a base alloy. The paper presents the effect of Cr, Mo, V and W on the crystallization process and the microstructure of HPDC aluminum alloy as well as an alloy from the shell mold. Thermal and derivative analysis was used to study the crystallization process. The possibility of increasing the mechanical properties of HPDC hypoeutectic alloy by addition of high-melting point elements has been demonstrated.

Dermoscopy of Cutaneous Graft-Versus-Host-Disease in Patients After Allogeneic Hematopoietic Stem Cell Transplantation.

INTRODUCTION: Progress in the transplant procedure has resulted in a higher proportion of patients with long-term survival after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Cutaneous graft-versus-host disease (GvHD) occurs often among patients who have undergone allo-HSCT. Routine diagnosis of skin and mucosal lesions is based primarily on clinical evaluation and histopathologic confirmation of skin biopsies. However, biopsy is an invasive method and histopathologic analysis is time-consuming, often accompanied by a lack of clinical correlation. There is therefore an urgent need for non-invasive, reproducible in vivo imaging methods that could be used in patients with cutaneous GvHD-both in the setting of initial diagnosis and during follow-up.The aim of the study reported here was to determine the role of dermoscopic monitoring of skin lesions in allo-HSCT recipients with consecutive histopathologic support as a non-invasive, alternative method to diagnose GvHD. METHODS: Twenty patients were examined by dermoscopy upon the manifestation of skin changes in the course of GvHD. Consecutive skin biopsies for histopathologic analysis were obtained from the suspected skin locations determined during dermoscopy. RESULTS: Graft-versus-host disease was confirmed by histopathology in 19 of the 20 allo-HSCT recipients. Four patients developed symptoms of acute cutaneous GvHD (grade 1, n = 2; grade 2, n = 1; grade 3, n = 1), and 15 patients developed chronic cutaneous GvHD. The most frequent dermoscopic signs (irrespective of whether GvHD was chronic or acute) were vessels and scaling (both n = 14, 73.7%). Hyperpigmentation and white patchy areas were present in eight patients (42.1%). Fair to moderate levels of agreement were found between presence of melanophages in the skin sample and dermoscopic granularity (Cohen's Kappa [κ] = 0.39), scaling (κ = - 0.3) and vessels (κ = - 0.42). The finding of white patchy areas was inversely associated with lymphocytic infiltration (κ = - 0.55). CONCLUSION: The results of this study suggest that dermoscopy may be a useful tool for diagnosing cutaneous GvHD in allo-HSCT recipients. Combining the clinical picture with dermoscopic features may bring us closer to a faster and easier diagnosis of GvHD.

The Association of SNPs Located in the CDKN2B-AS1 and LPA Genes With Carotid Artery Stenosis and Atherogenic Stroke.

Introduction: The aim of this project was to assess the prevalence of four selected SNPs rs4977574 and rs7857345 (CDKN2B-AS1 gene) and rs3798220 and rs10455872 polymorphisms (the LPA gene) in the subpopulation of patients with symptomatic and asymptomatic carotid stenosis. Material and Methods: This study included 623 individuals (244 patients with symptomatic carotid artery stenosis, 176 patients with asymptomatic carotid artery stenosis and 203 healthy people. All the participants underwent neurological examination, duplex Doppler ultrasound examination and molecular procedures. Results: In the first part of the analysis the assiociation of SNPs with stroke/TIA was investigated. The association was seen in symptomatic vs. control group for two SNPs: rs4977574 and rs7857345 (CDKN2B-AS1 gene); genotype distributions for rs4977574 and rs7857345 showed the statistically significant differences between patients and controls (p = 0.043 and 0.017, respectively). No association was observed for rs3798220 and rs10455872 located in the LPA gene. There were statistically significant differences between asymptomatic patients vs. control group in genotype distribution for the SNPs located in CDKN2B-AS1: rs4977574 and rs7857345 (p = 0.031 and 0.0099, respectively); and for the rs3798220 (LPA gene; p = 0.003); however, statistically significant differences did not occur for the rs10455872 polymorphism located in the LPA gene. In the next part of the evaluation, a comparison between symptomatic and asymptomatic patients was performed. Significant differences in genotype distribution were seen only for the rs3798220 polymorphism located in the LPA gene (p = 0.0015). The analysis of the prevalence of the polymorphisms in the total group (symptomatic and asymptomatic) patients in comparison with the control group showed significant differences for three polymorphisms: rs4977574 and rs7857345 (CDKN2B-AS1 gene; p = 0.015 and 0.0046, respectively) and rs3798220 (LPA gene, p = 0.044). Conclusions: The present research on the carotid artery stenosis patient cohort suggests the significant association between the rs4977574, rs7857345 and rs3798220 polymorphisms and carotid artery stenosis as well as between the rs4977574 and rs7857345 polymorphisms and atherogenic stroke. The rs4977574 and rs7857345 polymorphisms in patients with carotid artery stenosis appear to affect a person's susceptibility to atherogenic brain ischemia. Our results need to be replicated in future studies.

[Does coffee drinking influence serum uric acid concentration?]. / Czy picie kawy ma wplyw na stezenie kwasu moczowego w surowicy krwi?

The drinking of coffee, a commonly used beverage, was a subject of many studies, mainly regarded to coffee influence on cardiovascular system. However, only one study indicates that coffee drinking in male adults may lead to decrease in serum uric acid level. Hyperuricaemia is a risk factor of many diseases. The aim of this study was to examine the influence of coffee drinking on serum uric acid concentration. 1955 working persons aged from 18 to 65 years were included into research. There were 571 women among them. We determined energy expenditure during professional work, blood pressure, body mass index, and measured serum levels of uric acid, glucose and creatinine. The amount of coffee and ethanol consumption was evaluated on the ground of an interview. It was showed that persons drinking coffee have lower serum uric acid concentration than non-drinkers, especially among women, who drank more coffee then men. Uricaemia was correlated negatively with number of cups of coffee consumed and positively with body mass index, ethanol consumption and diastolic blood pressure. The author conclude that: 1) among women drinking on an average 10 cups of coffee per week appeared a decrease in serum uric acid concentration and a lower risk of development of hyperuricaemia, 2) elevated serum uric acid concentration is accompanied by elevated blood pressure and increased body mass index.

Plasma levels of leptin and orexin A in the restrictive type of anorexia nervosa.

OBJECTIVE: The aim of the study was to analyze the pattern of leptin and orexin A plasma levels in patients with the restrictive type of anorexia nervosa (AN-R), during the course of treatment. Thirty females with AN-R, aged 18.0 ± 1.6 years (mean ± SD), range of 15.5-21.0 years, were investigated before and after 2, 3, and 6 months of treatment, which included a normocaloric diet and cognitive-behavioral psychotherapy. The control group consisted of 20 age-matched, healthy control females. RESULTS: Before the therapy, both leptin and orexin A plasma levels were significantly lower than in the control group and were negatively correlated. During treatment, leptin levels increased and, after 6 months, showed a correlation with body mass index (BMI). Orexin A levels showed a further decrease during treatment, with no correlation with BMI. CONCLUSIONS: The results corroborate those of other researchers showing a decrease of leptin levels in patients with AN-R and its increase with body mass increment. They may also suggest a possible relationship between leptin and orexin A plasma level patterns in such patients.

Acute and late outcomes of unprotected left main stenting in comparison with surgical revascularization.

OBJECTIVES: The purpose of this study was to compare the early and late results of percutaneous and surgical revascularization of left main coronary artery stenosis. BACKGROUND: Unprotected left main coronary artery (ULMCA) stenting is being investigated as an alternative to bypass surgery. METHODS: We randomly assigned 105 patients with ULMCA stenosis to percutaneous coronary intervention (PCI; 52 patients) or coronary artery bypass grafting (CABG; 53 patients). The primary end point was the change in left ventricular ejection fraction (LVEF) 12 months after the intervention. Secondary end points included 30-day major adverse events (MAE), major adverse cardiac and cerebrovascular events (MACCE), length of hospitalization, target vessel failure (TVF), angina severity and exercise tolerance after 1 year, and total and MACCE-free survival. RESULTS: A significant increase in LVEF at the 12-month follow-up was noted only in the PCI group (3.3 +/- 6.7% after PCI vs. 0.5 +/- 0.8% after CABG; p = 0.047). Patients performed equally well on stress tests, and angina status improved similarly in the 2 groups. PCI was associated with a lower 30-day risk of MAE (p < 0.006) and MACCE (p = 0.03) and shorter hospitalizations (p = 0.0007). Total and MACCE-free 1-year survival was comparable. Left main TVF was similar in the 2 groups. During the 28.0 +/- 9.9-month follow-up, there were 3 deaths in the PCI group and 7 deaths in the CABG group (p = 0.08). CONCLUSIONS: Patients with ULMCA disease treated with PCI had favorable early outcomes in comparison with the CABG group. At 1 year, LVEF had improved significantly only in the PCI group. After more than 2 years, MACCE-free survival was similar in both groups with a trend toward improved survival after PCI.

Does the negative correlation found in breast cancer patients between plasma melatonin and insulin-like growth factor-I concentrations imply the existence of an additional mechanism of oncostatic melatonin influence involved in defense?

BACKGROUND: Insulin-like growth factor-I (IGF-I) is probably involved in promoting both normal and neoplastic cell growth, neoplastic transformation processes, angiogenesis, and neoplasma progression. On the other hand, one possible mechanism of the oncostatic action of melatonin is its influence on the action and/or release of the growth factors that stimulate neoplastic cell growth. Quantitative changes in melatonin and IGF-I, as well as an imbalance between melatonin and IGF-I, may affect the growth of breast cancer cells and exacerbate the disease. The aim of our research was to study the interactions between plasma melatonin and IGF-I concentrations in pre-menopausal breast cancer patients. MATERIAL/METHODS: Our research involved 24 breast cancer patients (mean age 43 +/-6) with stage II breast cancer (Bloom and Richardson classification), confirmed by histological studies, and were 4 weeks after radical mastectomy. The control group consisted of 16 healthy women volunteers (mean age 44 +/- 5). RESULTS: No statistically significant relations were found between mean plasma melatonin and IGF-I concentrations in the two study groups. In the breast cancer group the correlation coefficient between IGF-I concentration in plasma and melatonin was r = -0.392 (p = 0.058). CONCLUSIONS: The negative correlation between the plasma melatonin and IGF-I concentrations in the breast cancer patients we studied could reach statistical significance in a larger population. The presence of such a negative correlation between plasma melatonin and IGF-I concentrations in patients with neoplastic disease may imply the existence of an additional defense mechanism based on the oncostatic influence of melatonin.