Analysis of the geological control on the spatial distribution of potentially toxic concentrations of As and F- in groundwater on a Pan-European scale.

The distribution of the high concentrations of arsenic (As) and fluoride (F-) in groundwater on a Pan-European scale could be explained by the geological European context (lithology and structural faults). To test this hypothesis, seventeen countries and eighteen geological survey organizations (GSOs) have participated in the dataset. The methodology has used the HydroGeoToxicity (HGT) and the Baseline Concentration (BLC) index. The results prove that most of the waters considered in this study are in good conditions for drinking water consumption, in terms of As and/or F- content. A low proportion of the analysed samples present HGT≥ 1 levels (4% and 7% for As and F-, respectively). The spatial distribution of the highest As and/or F- concentrations (via BLC values) has been analysed using GIS tools. The highest values are identified associated with fissured hard rock outcrops (crystalline rocks) or Cenozoic sedimentary zones, where basement fractures seems to have an obvious control on the distribution of maximum concentrations of these elements in groundwaters.

Apelin-13 and Asprosin in Adolescents with Anorexia Nervosa and Their Association with Psychometric and Metabolic Variables.

Anorexia nervosa (AN) is a widespread, metabo-psychiatric disorder with high relapse rates, comorbidity, and mortality. Many regulatory proteins and neurohormones studied to date play essential roles in the etiopathogenesis of eating disorders and the maintenance of psychopathological symptoms. Nevertheless, the regulatory and pathophysiological mechanisms of AN are still poorly understood. In the presented study, the plasma levels of apelin-13 (APE-13) and asprosin (ASP), as well as carbohydrate metabolism parameters and psychometric parameters, were evaluated in low-weight adolescent female patients with AN (AN1), after partial weight normalization (AN2) and in an age-matched healthy control group (CG) were evaluated. APE-13 levels were higher in the AN1 group than in the post-realimentation and the CG group. APE-13 levels were independent of insulin and glucose levels. Plasma ASP levels increased with increasing body weight in patients with AN, correlating with the severity of eating disorder symptoms in emaciation. The presented data suggest that APE-13 and ASP may be AN's biomarkers-regulation of eating behavior by APE-13 and ASP, the close relationship between them and emotional behavior, and changes in neurohormone levels in patients with eating and affective disorders seem to support these hypotheses. Moreover, their plasma levels seem to be related to the severity of psychopathological symptoms of eating disorders.

The Effect of Physical Activity on Neurotrophin Concentrations and Cognitive Control in Patients With a Depressive Episode.

Background: Cognitive deficits occur in most patients with affective disorders. The role of neurotrophic factors (e.g., BDNF) as modulators of brain plasticity affecting neurocognitive abilities has been emphasized. Neurotrophin concentrations may change under the influence of various interventions, including physical activity. Selected studies have shown that cognitive function may also be affected by exercise. Aim: The aim of the study was to determine whether physical activity changes the concentration of neurotrophins and their receptors in patients with an episode of depression. It was also examined how one session of aerobic exercise affects cognitive control. Methods: The study included 41 participants. The subjects were asked to exercise on a cycloergometer for 40 min with individually selected exercise loads (70% VO2max). Before and shortly after the exercise blood samples were acquired to perform blood assays (proBDNF, BDNF, TrkB, NGFR). The participants also performed a Stroop test twice-before the exercise and 10 min after its cessation. Results: The single bout of physical exercise did not cause any significant changes in the concentration of neurotrophic factors. The SCWT results: both the mean reading time (29.3 s vs. 47.8 s) and the color naming time (36.7 s vs. 50.7 s) increased. The patients made more mistakes after physical exercise, both in part A (0.2 vs. 1.5) and B (0.6 vs. 1.5). The so-called interference effect decreased-the difference between naming and reading times was smaller after exercise (6.2 s vs. 2.4 s). No significant correlations were found between the concentrations of the studied neurotrophic factors and the Stroop test results. Conclusions: The results did not confirm changes in neurotrophin concentration under the influence of a single session of physical activity. The shortening of the interference time after exercise may be caused by practice effects. A significant limitation of the study is the use of the Stroop test twice in short intervals.

Screening procedure for 38 fentanyl analogues and five other new opioids in whole blood by liquid chromatography-tandem mass spectrometry.

In recent years, many new opioids, particularly fentanyl analogues, have appeared on the drug market. The extreme potency of even low doses of these compounds leads to numerous fatal poisonings. This also results in the fact that only sophisticated techniques are capable of detecting fentanyl analogues at concentrations that can be expected in blood. In this context, the purpose of this study was to develop a fast liquid chromatography-tandem mass spectrometry screening method for the detection of fentanyl analogues, and other new synthetic opioid receptor agonists in whole blood. Blood samples were extracted with ethyl acetate under basic conditions. The separation was achieved with the gradient of the mobile phase composition and the gradient of the flow rate in 13 minutes. The detection of all compounds was based on dynamic multiple reaction monitoring. Most of the compounds were well differentiated by their retention times and/or transitions; however, separation of some isomers has not been achieved. The validation was performed for 21 compounds. The limits of detection were in the range 0.01-0.20 ng/mL. The developed procedure enables simultaneous qualitative screening, detection and identification of 38 fentanyl analogues and five other new opioids. The method was implemented to analyze authentic samples (positive; n = 3) demonstrating its suitability for this application. The procedure can be easily expanded to include new emerging opioids, which is an indispensable advantage in the dynamically developing drug market. The developed protocol can be adopted for routine work in both forensic and clinical analytical laboratories worldwide.

Complications in cardiac surgery: An analysis of factors contributing to sternal dehiscence in patients who underwent surgery between 2010 and 2014 and a comparison with the 1990-2009 cohort.

BACKGROUND: Sternal dehiscence is a serious postoperative complication of cardiac surgery observed in 0.2-5% of procedures performed by median sternotomy. OBJECTIVES: Assessment of factors, including the method of sternum closure, which may affect the incidence of this complication. MATERIAL AND METHODS: A total of 5,152 consecutive patients undergoing surgery with median sternotomy access in the Cardiac Surgery Department of the Pomeranian Medical University between 2010 and 2014 were included in the study. The analysis centered on cases of sternal dehiscence, which occurred in 45 patients (0.9%). RESULTS: Factors such as age (p < 0.05), body mass (p < 0.005) and coronary artery bypass surgery (CABG) (p < 0.005) were found to be significant risk factors. Diabetes and chronic obstructive pulmonary disease (COPD) also had an impact on an increased risk of sternal dehiscence (p < 0.006 and p < 0.015). However, the differences were only significant in the whole study group. Apart from CABG, the type of operation did not affect the incidence of dehiscence. Logistic regression analysis found independent risk factors for the development of sternal dehiscence: body mass index (BMI) (odds ratio (OR): 2.1; p < 0.019), diabetes (OR: 2.4; p < 0.004), COPD (OR: 2.7; p < 0.016), and redo procedure (OR: 3.0; p < 0.014). There were no significant differences in postoperative mortality between these groups - 6.7% in the group with sternal dehiscence and 3.9% in the group without dehiscence. CONCLUSIONS: Introducing a more durable sternum stabilization method with 8+ loops helped to improve conditions for bone union and reduced the risk of dehiscence. Therefore, we suggest that centers which still use 6-loop sternal closure should consider shifting to a stronger technique.

Augmentation of Pharmacotherapy by Sleep Deprivation with Sleep Phase Advance in Treatment-Resistant Depression.

INTRODUCTION: The aim was to assess the efficacy of total sleep deprivation (TSD) with sleep phase advance (SPA) in treatment-resistant depression (TRD) and associated biochemical factors. METHODS: We studied nine males and 12 females, aged 49±14 years, with treatment-resistant unipolar or bipolar depression, receiving antidepressant and mood-stabilizing drugs. The four-day schedule included single TSD and three consecutive nights with SPA. Biochemical markers were measured on the day before and on 1st, 7th and 14th day after the TSD. RESULTS: Ten subjects met criteria for response, defined as a reduction of ≥50% in the Hamilton Depression Rating Scale, on the 14th day. Concentrations of cortisol at baseline were lower in responders, and they decreased during therapy in both groups. In responders, there was an increase of interleukin-10 (IL-10) and IL-1ß on the 14th day. DISCUSSION: Our preliminary study demonstrated the efficacy of pharmacotherapy augmentation by TSD and SPA in half of the patients with TRD. The main biochemical factors related to clinical response included status of cortisol and increase in IL-10 and IL-1ß levels.

The Relationship between Diabetes Mellitus and Respiratory Function in Patients Eligible for Coronary Artery Bypass Grafting.

Introduction: Spirometry performed prior to surgery provides information on the types of lung disorders in patients. The purpose of this study was to look for a relationship between the prevalence of diabetes and spirometry parameters. Material and Methods: The study was conducted in patients with coronary artery disease who were eligible for an isolated coronary artery bypass graft in 2013. The study group included 367 patients (287 men and 80 women) aged 68.7 ± 8.4 years. They were divided into those with diagnosed diabetes (group I, n = 138, 37.6%) and without diabetes (group II, n = 229, 62.4%). Spirometry tests were performed on the day of admission to the hospital. Results: Patients with diabetes (group I) had a significantly higher body mass index than those without diabetes (group II). Spirometry tests also showed that patients with diabetes had statistically significantly lower forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1.0). Both FVC and FEV1.0 were also statistically significantly lower for overweight and obese individuals in group I than those in group II. Conclusion: Patients with diabetes eligible for coronary artery bypass grafting with concurrent overweight or obesity are more likely to have lower spirometry parameters than those without diabetes.

[Effect of low -level laser therapy and exercise in reducing the symptoms of disease in patients with osteoarthritis of the knee].

Introduction: Osteoarthritis is the most common disease of the joints contributing to the failure of movement. The disease mostly affects the older part of the population, and is associated with suffering and reduced quality of life. Knee osteoarthritis contributes to joint dysfunction of varying severity. These are common causes of chronic ailments limiting physical activity, which may even complicate the performance of activities of daily living. Low-level laser therapy is thought to have an analgesic effect, as well as a biomodulatory effect on the microcirculation. The aim of this study was to evaluate the effectiveness of low- -level laser therapy on pain relief and functional improvement in patients with osteoarthritis of the knee. The effects of laser therapy alone and in combination with exercise were compared. Materials and methods: 40 patients of mean age 65 years with knee osteoarthritis of both sexes were divided into two groups. Laser alone was used in group I (n = 20) and laser combined with kinesistherapy was used in group II (n = 20). All patients received the same dose of laser radiation, which was 3.0 J/cm², 10 Hz, 400 mW. In both groups a series of 10 treatments was performed daily. VAS, ranges of motion in the knee joint, and the strength of the quadriceps and biceps femoris muscles were used as the criteria of pain assessment in both groups. All measurements were taken before and after treatment. Results: Significant pain reduction: I (p = 0.00009, R = 0.68); II (p = 0.00002, R = 0.86), increased range of flexion in the knee: I (p = 0.000001, R = 0.90); II (p = 0.00002, R = 0.85), increased range of extension in the knee: I (p = 0.042, R = 0.87); II (p = 0.0004, R = 0.9) and increased strength of the quadriceps femoris muscle: I (p = 0.03, R = 0.77); II (p = 0.0002, R = 0.9) and the biceps femoris muscle: I (p = 0.04, R = 0.80); II (p = 0.0007, R = 0.91) were found in both groups after treatment. With the exception of flexion of the knee (p = 0.027; r = 0.17), there were no statistically significant differences in other analysed parameters between the use of laser alone and laser therapy combined with exercise. Conclusion: The use of laser in knee osteoarthritis reduces pain and improves the functional status of the patient. Laser therapy combined with kinesistherapy produces better therapeutic effects, and effectively improves the functional status of knee osteoarthritis. Exercise therapy applied in a series of 10 treatments is too short to significantly improve the functional status of the patient.

[Myokinesiotherapy as a form of rehabilitation in maxillary orthopaedics]. / Miokinezyterapia jako forma rehabilitacji w ortopedii szczekowej.

During early childhood the masticatory system is susceptible to negative exo- and endogenous factors. Untreated functional and morphological disorders provoke serious consequences in adolescence. Myokinesiotherapy is a concept of exercise involving facial muscles and the masticatory system, with the main objective of preventing and treating malocclusions.

[USE OF THE STRUCTURAL TENSEGRATION CONCEPT IN THE STECCO FASCIAL MANIPULATION METHOD]. / ZASTOSOWANIE KONCEPCJI TENSEGRACJI STRUKTURALNEJ W MANIPULACJACH POWIEZIOWYCH© WEDLUG STECCO.

Low therapeutic efficacy in a number of cases involving the musculoskeletal system may be caused by a wrong diagnosis, the misunderstanding of the essence of the problem, pathogen or improper treatment. Therapy may be applied to the wrong area (at the site of pain) or may cover an area that is too small. The paper presents the theory of structural tensegrity (along with the anatomical and physiological grounds), which is based on a number of modern holistic therapies. One such method is the method of fascial manipulation by Stecco, described in outline in this article. This article also describes the structure and functions of the fascia since understanding of this structure was the cause of the emergence of new concepts and therapies.

[Evaluation of vibration exposure long-term effects in people with diagnosed vibration syndrome]. / Ocena odleglych skutków zdrowotnych narazenia na wibracje miejscowa u osób z rozpoznanym zespolem wibracyjnym.

BACKGROUND: Long-term exposure to hand-transmitted vibration can increase the occurrence of symptoms and signs of vascular neurological and musculoskeletal disorders of the upper extremities. The most common is the angioneurotic type of the vibration syndrome. Very little is known about possibility of withdrawal of symptoms after exposure cessation. OBJECTIVES: The aim of the study was to evaluate the long-term effects of vibration exposure in people with diagnosed vibration syndrome. The particular aim of the study was to gain the information on possible withdrawal of symptoms in the peripheral vascular and nervous system after exposure cessation. MATERIALS AND METHODS: The medical documentation of patients with vibration syndrome symptoms, examined in the years 1999-2004 in the Outpatient Clinic of the Nofer Institute of Occupational Medicine and in three Voivodeship Centers of Occupational Medicine has been analyzed. RESULTS: A group of 45 people who had been suffering from diagnosed angioneurotic vibration syndrome for at least 5 years was chosen. The mean age of the examined group at the time of occupational disease certification was 48.2 and the mean period of exposure to hand-transmitted vibration was nearly 20 years. The major group comprised persons with vibration syndrome diagnosed at an 'early symptoms' stage, an advanced stage of the disease was described in only 5 cases. From the time of occupational disease certification only 7 persons have been performing any job, and more than a half of the group has been granted disability pension. CONCLUSIONS: The results of the study show a bad prognosis of angioneurotic vibration syndrome despite cessation of the exposure to vibration. The total withdrawal of symptoms is possible only in people with vibration syndrome diagnosed at an 'early symptoms' stage, at young age and after short period of exposure.

Nicotinic acid adenine dinucleotide phosphate regulates skeletal muscle differentiation via action at two-pore channels.

Calcium signaling is essential for the differentiation of many cell types, including skeletal muscle cells, but its mechanisms remain elusive. Here we demonstrate a crucial role for nicotinic acid adenine dinucleotide phosphate (NAADP) signaling in skeletal muscle differentiation. Although the inositol trisphosphate pathway may have a partial role to play in this process, the ryanodine signaling cascade is not involved. In both skeletal muscle precursors and C2C12, cells interfering with NAADP signaling prevented differentiation, whereas promoting NAADP signaling potentiated differentiation. Moreover, siRNA knockdown of two-pore channels, the target of NAADP, attenuated differentiation. The data presented here strongly suggest that in myoblasts, NAADP acts at acidic organelles on the recently discovered two-pore channels to promote differentiation.

[Metabolic syndrome in young adults type 1 diabetic patients]. / Zespól metaboliczny u mlodych doroslych chorych na cukrzyce typu 1.

AIM: The aim of the study was to estimate the prevalence of metabolic syndrome (MS) in type 1 diabetic patients and to assess the relationship between the scores of MS components and body mass and metabolic control. MATERIAL AND METHODS: 165 patients aged 18-32 years with diabetes duration 8-26 years were included into the study. The height, weight, waist circumference and blood pressure were measured. HbA1c and plasma lipids concentrations were examined. Body mass index (BMI), waist/hip ratio (WHR) and daily dose of insulin were calculated. MS was diagnosed according to the definition of National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP) and International Diabetes Federation (IDF). RESULTS: The prevalence of individual components of MS was 10.3% for high triglycerides, 7.3% for low HDL, 27.9% for high blood pressure, and 10.3% for abnormal waist circumference according to NGEP and 18.8% according to IDF definition. After assuming that all type 1 diabetic patients fulfilled criteria for hyperglycemia, the prevalence of MS diagnosed according to NCEP was 10.9% (95% CI 6.1-15.7) and according to IDF was the same 10.9% (95% CI 6.1-15.7). In 14 patients MS was diagnosed according to both definitions, whereas 4 met only the NCEP, and another 4 met only the IDF criteria. Rrelationships between the scores of MS components and BMI (p < 0.0001) and HbA1c (p = 0.002) were found. Patients with MS were older than the patients without MS (p = 0.003) and needed higher insulin doses (p = 0.028). CONCLUSIONS: According to the NCEP and IDF criteria similar prevalence of MS is recognized in type 1 diabetic patients. Only in 2/3 of them MS is diagnosed according to both definitions. The most frequently occurring component of MS is elevated blood pressure. The scores of MS components are related to the presence of overweight and to poor metabolic control.

[Bourneville-Pringle disease. Case report]. / Choroba Bourneville'a-Pringle'a. Opis przypadku.

We present a case of a 47-year-old woman suffering from Bourneville-Pringle disease and uterus cancer undergoing radical operation. Surgery was performed under general anaesthesia and went uneventfully.

[Intramural hearing protection program as a response to health needs of working populations in the region of Swietokrysk]. / Zakladowy program ochrony sluchu jako odpowiedz na potrzeby zdrowotne populacji pracujacych z terenu województwa Swietokrzyskiego.

The program of health promotion in the area of hearing protection (IHPP) is proposed as a part of Operational Target 8 of the National Health Program "Reducing exposure to harmful factors in the living, working and educational environment and mitigating their health effects" and corresponds with the aims of the Strategic Governmental Program on Health Protection and Safety at Work. Both in Poland and in the region of swietokrzyskie there is an urgent need to undertake appropriate steps to protect the hearing organ in the working population against harmful effects present in the work environment. It is estimated that 25% of diagnosed occupational diseases is associated with occupational hearing loss. The program is addressed to workers exposed to noise at work. To achieve the main goal of the program it is necessary: to reduce noise emissions and exposure to noise in the work environment; to promote behavior conducive to hearing protection among workers exposed to noise; to improve the quality of prevention in the occupational health services responsible for hearing protection. The Regional Center of Occupational Medicine in Kielce (coordinator) and primary units of occupational health service are involved in the implementation of the program, whereas, employers, occupational safety and health services, the State Labor Inspectorate and Sanitary Inspectorate participate in its implementation. It is expected that the program in the region of swietokrzyskie will yield the following expected results: the reduction of noise emission to safe levels; the increased awareness of using optimal hearing protectors among noise-exposed workers; the decreased number of workers with diagnosed noise-induced hearing loss, and the decrease in the number of new cases of occupational hearing impairment.