[Medical group practice in primary care in six European countries, and the Canadian provinces of Ontario and Quebec: what are the lessons for France ?]. / La pratique collective en soins primaires dans six pays européens, en Ontario et au Québec : état des lieux et perspectives dans le contexte français.

Medical group practice in primary care remains comparatively undeveloped in France compared to other countries. In Finland and Sweden, doctors are grouped in local public structures with multidisciplinary teams, whereas in Canada, the Netherlands and the United Kingdom, they are organized in private units run by independent health professionals on a contractual basis. Among the factors explaining this trend, mention should in particular be made of a genuine political determination to place primary care at the heart of the health system and a definite change in health care supply and demand. This grouping often goes hand in hand with new rules and practices: voluntary registration procedures for patients with a doctor in group practice, greater cooperation between health professionals, changes in doctors' remuneration and new contracts between groups and health authorities. Certain signs are already visible in France, doubtless presaging an acceleration in the trend towards medical group practice.

Transcriptional activity of TGFß1 and its receptors genes in thyroid gland.

INTRODUCTION: Determination of gene-candidates' profile expression responsible for fibrosis, immunosuppression, angiogenesis, and neoplasia processes in the pathogenesis of thyroid gland disease. MATERIAL AND METHODS: Sixty-three patients underwent thyroidectomy: 27 with non-toxic nodular goitre (NG), 22 with toxic nodular goitre (TNG), six with papillary cancer (PTC), and eight with Graves' disease (GD). In thyroid tissues, transcriptional activity of TGFbeta1 and its receptors TGFbetaRI, TGFbetaRII, and TGFbetaRIII genes were assessed using RT-qPCR (Reverse Transcriptase Quantitative Polymerase Chain Reaction). Molecular analysis was performed in tissues derived from GD and from the tumour centre (PTC, NG, TNG) and from peripheral parts of the removed lobe without histopathological lesions (tissue control). Control tissue for analysis performed in GD was an unchanged tissue derived from peripheral parts of the removed lobe of patients surgically treated for a single benign tumour. RESULTS/CONCLUSIONS: Strict regulation observed among transcriptional activity of TGFb1 and their receptor TGFbetaRI-III genes in control tissues is disturbed in all pathological tissues - it is completely disturbed in PTC and GD, and partially in NG and TNG. Additionally, higher transcriptional activity of TGFb1 gene in PTC in comparison with benign tissues (NG, GD) and lower expression of mRNA TGFbRII (than in TNG, GD) and mRNA TGFbetaRIII than in all studied benign tissues (NG, TNG, GD) suggests a pathogenetic importance of this cytokine and its receptors in PTC development. In GD tissue, higher transcriptional activity of TGFbetaRII and TGFbetaRIII genes as compared to other pathological tissues was observed, indicating a participation of the receptors in the pathomechanism of autoimmune thyroid disease (AITD). TGFbeta1 blood concentrations do not reflect pathological processes taking place in thyroid gland. (Endokrynol Pol 2016; 67 (4): 375-382).

The HLA-DQß1 insertion is a strong achalasia risk factor and displays a geospatial north-south gradient among Europeans.

Idiopathic achalasia is a severe motility disorder of the esophagus and is characterized by a failure of the lower esophageal sphincter to relax due to a loss of neurons in the myenteric plexus. Most recently, we identified an eight-amino-acid insertion in the cytoplasmic tail of HLA-DQß1 as strong achalasia risk factor in a sample set from Central Europe, Italy and Spain. Here, we tested whether the HLA-DQß1 insertion also confers achalasia risk in the Polish and Swedish population. We could replicate the initial findings and the insertion shows strong achalasia association in both samples (Poland P=1.84 × 10(-04), Sweden P=7.44 × 10(-05)). Combining all five European data sets - Central Europe, Italy, Spain, Poland and Sweden - the insertion is achalasia associated with Pcombined=1.67 × 10(-35). In addition, we observe that the frequency of the insertion shows a geospatial north-south gradient. The insertion is less common in northern (around 6-7% in patients and 2% in controls from Sweden and Poland) compared with southern Europeans (~16% in patients and 8% in controls from Italy) and shows a stronger attributable risk in the southern European population. Our study provides evidence that the prevalence of achalasia may differ between populations.

["Diary of health of every estate" and children's issues]. / "Dziennik zdrowi dla wszystkich stanów" a problematyka dziecieca.

L. Lafontaine's "Diary of Health for Every Estate" including children's issues was being published from 1801 to 1802. It was the first Polish magazine addressed to the whole society. In its author's opinion this magazine was to propagate rules of hygiene, sanitary education and inform about methods of proceeding in different cases. Lafontaine devoted a lot of attention to sickness affecting mostly the poor and uneducated. He was the first to mention the problem of sick children. In articles, he refer to naturalism and Locke's and Rousseau's ideas. He mentioned and described defects, symptoms and children's illnesses from birth till adult. He talked over rules of physical behaviour and indispensable remedies for treatment in home. He was the man of merit in trying standardization of medical onomastics creating basis to develop independent paediatrics science.

[19th-century medical treatment of childhood diseases]. / Dziewietnastowieczne srodki medyczne wykorzystywane w terapii chorób dzieciecych.

In the 19th century, illnesses, including those of children, were treated at home. That pertained to urban as well as rural children alike. In the impoverished Polish countryside, medical treatment was largely confined to the folk-medicine practices that had been passed down from one generation to another. In rural villages and small towns, where doctors of medicine were few and far between, the parents of sick children would seek the help of folk healers or simply older women who made use of various herbal remedies. Such treatment was of a symptom-relieving nature and therefore affected the young patient's entire system. Children were also treated in their homes and family circles in cities. One can even distinguish a characteristic form of therapy which might be referred to as home medicine. It made use of a variety of therapeutic methods carried out in a domestic setting by physicians or parents. Usually those methods were based on traditional folk superstitions, additionally bolstered by rational premises. Generally accessible means, not only herbs but also diets, hydrotherapy, blood-letting and pharmacological preparations were used to treat sick children at home.

[The child's hospital in Europe]. / Szpitale dzieciece w Europie 1802-1908.

There weren't child's hospital in Europe until the beginning of the nineteenth century. The need for child's treatment wasn't perceived. Rich people took care of ill children in their homes but poor children were deprived of care or were hospitalized in the hospitals for adults, where they were treated as men and women. Even existence of asylums didn't solve the problems with unwanted, abandoned and ill children. The first hospital for children was built in 1802 in Paris. It was the biggest child's hospital in Europe for a long time (it had 300 beds). Next hospitals were built in Petersburg (1834), Wieden and Wroclaw (1837), Praga and Moskwa (1842), Berlin (1843), Londyn (1847) and Kopenhaga (1850). At the beginning of the twentieth century there were about 200 hospitals for children all over the world. The most hospitals were in the Germany, the Austro-Hungary and the Great Britain.

[Children's diseases in the columns of "The Weekly Medicine"]. / Choroby noworodków i niemowlat na lamach "Tygodnika Lekarskiego" 1848-1868.

"The Weekly Medicine", the first scientific weekly journal, was published in Warsaw in the years 1847-1868. Its editor and publisher was L. Natanson. The weekly comprised original works, translations from foreign periodicals, books reviews, correspondence, biographies and reports from for example the Warsaw Medical Society. A lot of attention devoted to sickness from birth till adult. In "The Weekly Medicine" wrote polish authors and were very articles translations from foreign periodicals. Authors talked about younger children's illnesses: hydrocephalus, conjunctivitis, thrush, diarrhoea, convulsions, pleurisy, liver cancer, syphilis and teething. In articles have been descriptioned sickness and treatmented. Information about children's illnesses creating basis to develop independent pediatrics science.

[The socio-political involvement of physicians with ties to the Lódz-based 'Czasopismo Lekarskie' ('Physicians' Journal') in the years 1899-1908]. / Dzialalnosc spoleczno-polityczna lekarzy zwiazanych z lódzkim "Czasopismem Lekarskim" w latach 1899-1908.

In 1899, at the initiative of J. Kolifnki and S. Sterling a journal entitled 'Czasopismo Lekarskie' was established in Lódz The monthly publication was meant for provincial physicians, especially factory-affiliated and country doctors who wished to improve their professional qualifications. In addition to their professional careers as well as editorial and publishing activities, the physicians connected with 'Czasopismo Lekarskie' were also social activists. They worked to improve the working conditions of workers and the conditions in Polish schools. They set up new hospitals, wards and treatment facilities. They also Joined the war on alcoholism, contagious diseases, venereal disease and cancer, and took an active part in public life. 'Czasopisnm Lekarskie' was published until 1908.

[The story of the Wilhelm Malcz's "Warsaw Medical Journal" (1828-1829)]. / Dzieje i problematyka "Pamietnika Lekarskiego Warszawskiego" Wilhelma Malcza (1828-1829).

The "Warsaw Medical Journal" (Pamietnik Lekarski Warszawski), the first Polish scientific medical journal, was published in Warsaw in the years 1828 and 1829. Its editor and publisher was W. Malcz - a great social activist and distinguished doctor. The articles were written mainly by doctors, but also by pharmacists and a writer, who informed readers about the development of medicine at home and abroad, enabled them to raise their professional qualifications, and encouraged them to engage in academic and literary activity. The articles comprised original works, sophistry, translations from foreign periodicals, descriptions of new instruments, book reviews and correspondence from Paris. The range of topics in the "Warsaw Medical Journal" was very broad. Articles covered internal and external diseases and pharmacology. In 1830 the journal was made the official organ of the Warsaw Medical Society. But then the November Uprising broke out, and prevented the journal's further development.

The dynamics of the oxidant-antioxidant balance in the early phase of human acute biliary pancreatitis.

BACKGROUND/AIM: Reactive oxygen species play an important role in the pathogenesis of acute pancreatitis (AP) in animal models. Data on the oxidant-antioxidant balance in humans are scanty. The present study was undertaken to evaluate the dynamics of changes in the oxidant-antioxidant balance in the early phase of human AP. METHODS: 74 consecutive patients with acute biliary pancreatitis (16 with severe, 58 with mild pancreatitis), treated endoscopically, were included in the study. Serum concentrations of sulfhydryl groups (SH; main nonenzymatic antioxidant; 73 patients) and thiobarbituric acid reactive substances (TBARS; markers of reactive oxygen species-mediated tissue damage; 56 patients) were determined on admission and on each of 10 successive days. The analysis comprised the comparison of results in patients with mild and severe outcome of pancreatitis. RESULTS: Serum SH dropped by 27%, reaching the trough level on day 4 of hospitalization, whereas serum TBARS rose by 28%, reaching a peak 1 day later. Neither SH nor TBARS returned to initial values at the end of observation. The most dynamic changes in both SH and TBARS concentrations occurred in the first 3 days of hospitalization. The changes were significantly greater in patients with complicated pancreatitis in comparison to patients with mild disease, and were most pronounced in patients who developed infected pancreatic necrosis and who subsequently died. CONCLUSIONS: The oxidant-antioxidant balance changes rapidly in the early phase of human AP, confirming the role of oxidative stress in the pathogenesis of AP. The degree of changes correlates with the clinical severity of pancreatitis.

Multivariate analysis of risk factors for development of duodenal ulcer in Helicobacter pylori-infected patients.

BACKGROUND: Although Helicobacter pylori is a significant etiologic factor of peptic ulcer disease, it remains unknown why ulcers develop only in the minority of infected individuals. AIM: The aim of this cross-sectional study was to evaluate the association between the presence of duodenal ulcer in H. pylori-infected patients and different risk factors. METHODS: A total of 122 H. pylori-infected patients were enrolled; 79 had duodenal ulcer and 43 gastritis. Univariate analysis was conducted using either Fisher's exact test or exact Cochrane-Armitage trend test. In multivariate analysis the logistic model was used. RESULTS: Univariate analysis indicated six factors (male sex, smoking, antral H. pylori density, CAGA presence in antrum, and VACA s1a presence in antrum and corpus). Four factors (sex, smoking-alcohol index, H. pylori density index, and CAGA index) were found to be significant in multivariate analysis. The best model predicting duodenal ulcer included male sex, smoking, presence of H. PYLORI on histopathology in antrum and CAGA presence in corpus. CONCLUSION: Although several risk factors were significantly associated with duodenal ulcer, we failed in the identification of either a single risk factor or a set of factors that can unequivocally differentiate patients with ulcer from those with gastritis.