Interleukin-6 Family of Cytokines in Cancers.

Nine soluble ligands [interleukin-6 (IL-6), interleukin-11 (IL-11), leukemia inhibitory factor (LIF), oncostatin M (OSM), ciliary neurotrophic factor (CNTF), cardiotrophin-1 (CT-1), cardiotrophin-like cytokine, interleukin-27 (IL-27), and interleukin-31] share the ubiquitously expressed transmembrane protein-glycoprotein-130 beta-subunit (gp130) and thus form IL-6 family cytokines. Proteins that may be important for cancerogenesis, CT-1, IL-11, IL-27, LIF, OSM, and CNTF, belong to the superfamily of IL-6. Cytokines such as IL-6, IL-11, and IL-27 are better investigated in comparison with other members of the same family of cytokines, eg, CT-1. Gp130 is one of the main receptors through which these cytokines exert their effects. The clinical implication of understanding the pathways of these cytokines in oncology is that targeted therapy to inhibit or potentiate cytokine activity may lead to remission in some cases.

The Mental Health of Poles during the COVID-19 Pandemic.

BACKGROUND: The SARS-Cov-2 pandemic has had a profound impact on all aspects of life in the global population, causing above other, psychological problems. AIMS: The objective of this study was to evaluate the mental health of the Poles during the COVID-19 pandemic. METHODS: A prospective, cross-sectional web-based survey design was adopted. The study horizon was from 1 June 2021, to 31 December 2021. An anonymous, standardized questionnaire was disseminated electronically by means of social media among Polish adults. The following tests were performed: Depression, Anxiety, and Stress Scale (DASS-21), and the Insomnia Severity Index (ISI). RESULTS: A total of 1306 individuals completed the survey. Of the participants, 77.79% were female at a mean age of 34.89 ± (14.79), 62.25% had higher education, and 56.43% were employed. The prevalence of depression, anxiety, stress, and sleep disturbances in this sample were as follows: 50.38%, 43.49%, 61.26%, and 44.74%, respectively. Poor self-estimated health status, the presence of comorbidities, and regular use of nicotine significantly increased the risk of any of the analyzed psychiatric symptoms and sleep disorders. The depression level was significantly associated with age, living alone, health status, and the use of nicotine. Moreover, the level of anxiety was significantly associated with age and health status. The level of stress depended on gender, age, health status, use of nicotine, and being vaccinated against SARS-CoV-2. Sleep disturbances depended on age, health status, the presence of comorbidities, and regular use of drugs. CONCLUSIONS: The Polish population manifested numerous psychological symptoms during the COVID-19 pandemic. There is a need to afford psychological support to them and ensure their mental health.

Adherence of Obese Patients from Poland and Germany and Its Impact on the Effectiveness of Morbid Obesity Treatment.

This study aimed to investigate and compare the adherence of patients treated for morbid obesity living in Poland and Germany. Methods: A cross-sectional international multicenter survey design was adopted. The study involved 564 adult subjects treated for morbid obesity at selected healthcare facilities in Germany (210 participants) and Poland (354 participants). A validated, custom-made questionnaire based on the literature related to this issue was used. Results: The degree of adherence was higher, but not statistically significant, among Polish patients (83.82% vs. 78.33%, p = 0.26140). Patient adherence was associated with gender, age, level of education, duration of obesity, number of health professionals involved in obesity treatment, and type of obesity treatment (p < 0.05). A positive correlation was observed in the case of age, level of education, and a growing number of health professionals involved in obesity treatment, whereas a negative correlation was observed in the case of the duration of obesity. Patients who underwent bariatric surgery significantly more often followed medical recommendations regarding lifestyle changes, compared to obese participants treated only conservatively. Adherence in the field of obesity treatment significantly increases the percentage of total weight loss and excess weight loss due to applied obesity treatment among both Polish and German groups (p < 0.001). Both the percentage of total weight loss and that of excess weight loss were significantly higher in the group of adherent patients compared to the nonadherent patients (p < 0.00001). The levels of perceived anxiety, stress, and depression were significantly higher in nonadherent patients in both countries. Conclusions: These findings confirm the role of adherence in the effective and satisfactory treatment of morbid obesity. There is a great need to improve patient adherence to overcome the consequences of the obesity pandemic.

Comparison of Perceived Weight Discrimination between Polish and German Patients Underwent Bariatric Surgery or Endoscopic Method versus Conservative Treatment for Morbid Obesity: An International Multicenter Study.

Objectives: The aim of this study was to compare the level of discrimination among patients with obesity living in Poland and Germany. Methods: This was a retrospective cross-sectional international multicenter survey study including 564 adult participants treated for morbid obesity at selected healthcare facilities in Germany (210 patients) and in Poland (354 patients). Discrimination was evaluated using a custom-made questionnaire based on the related literature. Results: The level of obesity discrimination did not differ between German and Polish patients (p = 0.4282). The presence of obesity was reported to be associated to a large or a very large extent with the feeling of social exclusion and discrimination by 46.63% of German participants and 42.09% of Polish ones (p = 0.2934). The mean level of discrimination related to the lack of employment was higher in patients who underwent bariatric surgery or endoscopic method than in those who underwent conservative treatment (for Germany: 2.85 ± 1.31 (median, 3) vs. 2.08 ± 1.31 (median, 1), p = 0.002; for Poland: 2.43 ± 1.15 (median, 2) vs. 1.93 ± 1.15 (median, 1), p = 0.005). The level of discrimination was associated with sex, age, the degree of obesity, and treatment-related weight loss (p < 0.05). Conclusions: Our findings confirm that obesity significantly affects the social and economic well-being of patients. There is a great need to reduce weight stigma and to take measures to alleviate the socioeconomic and psychological burden of obesity.

Impact of bariatric surgery on depression, anxiety and stress symptoms among patients with morbid obesity: international multicentre study in Poland and Germany.

BACKGROUND: There is a need to investigate how adopting different strategies for treating obesity in different countries in the European Union affects the psychological well-being of patients. AIMS: The aim of this study was to perform a comparative evaluation of psychiatric symptoms (depression, anxiety and stress) in patients undergoing bariatric surgery versus patients receiving conservative treatment for morbid obesity in Poland and Germany. METHOD: A multicentre international prospective cohort study with 155 patients who underwent bariatric surgery and 409 patients who received conservative weight reduction treatment. Evaluation of the psychiatric symptoms was carried out for each patient at baseline and after 12 months of active treatment using a standardised Depression Anxiety Stress Scale questionnaire (DASS-21) questionnaire. RESULTS: After 12 months of active treatment, the level of psychiatric symptoms (depression, anxiety and stress) significantly decreased in both groups of patients: surgically treated versus conservatively treated patients from Poland and also from Germany. The median change in level of psychiatric symptoms among patients from both countries was significantly higher among surgically treated patients compared with conservatively treated patients (Poland P < 0.0001; Germany P < 0.0001). Improvements in the patient's mental health as a consequence of treatment were dependent on the specific strategy for treating obesity adopted in the analysed countries, the percentage of total weight loss and on gender. CONCLUSIONS: The use of bariatric surgery in both Poland and Germany compared with non-surgical treatment for obesity resulted in more measurable benefits in the form of a decrease in psychiatric symptoms (depression, anxiety and stress) and reduction in body weight.

Peripheral T-Cell Lymphoma Possibly Due to Unrecognized Celiac Disease in an Elderly Patient: A Case Report.

Celiac disease (CD) is widely perceived as a childhood disorder. However, it has been demonstrated that 19-34% of new CD cases are diagnosed in patients over 60 years of age and lack the typical presentation. A 76-year-old female was admitted to the clinic due to a recurrent fever that had lasted over a year accompanied by progressive weakness, weight loss of about 10 kg, dehydration, and malnutrition. The patient had undergone resection of a fragment of the small intestine due to perforation and abscess 13 years previously (at which time no histopathological examinations were performed). During the current hospitalization, despite extensive laboratory, microbiological, and imaging tests, no specific diagnosis was made. Symptomatic treatment and empirical antibiotic therapy were conducted, but the patient died on the twenty-seventh day of hospitalization due to progressive respiratory failure. The autopsy revealed peripheral T-cell lymphoma in the mesentery of the small intestine, uterus, cecum, lung, and mediastinal lymph nodes. Based on the clinical picture, we believe that the lymphoma was induced by long-term, undiagnosed CD. Current knowledge allows us to see age-related differences in the manifestation of celiac disease and to be alert to the possible late-stage complications of the disease. The lack of awareness of how CD's symptoms vary with age may lead to misdiagnosis and serious consequences of delayed diagnosis, including death.

Managing metastatic bone pain: New perspectives, different solutions.

Bone metastases are the most frequent cause of cancer-induced bone pain (CIBP). Although palliative radiotherapy and pharmacotherapy conducted according to World Health Organization (WHO) analgesic ladder are the treatment of choice for CIBP reduction, these methods are not always successful, especially with regard to alleviation of incidental pain. Antiresorptive drugs (bisphosphonates) are able to inhibit bone destruction (loss), proliferation of cancer cells and angiogenesis, but their prolonged use may lead to a spectrum of adverse effects. In this paper, types of bone metastases, their complications, as well as diagnostic and therapeutic implications are presented. Moreover, the paper discusses presently used CIBP treatment methods and research directions for future methods, with special focus on bone metastases.

Compliance Among Adolescents with Arterial Hypertension.

BACKGROUND: The term "compliance" means the degree to which the patient's behavior, applying medication or certain lifestyle changes, is consistent with arrangements communicated to him by a doctor or other healthcare professional. Literature indicates that the degree of adherence to medical recommendations for hypertensive patients is unsatisfactory, making it the main cause of the low effectiveness of antihypertensive therapy. OBJECTIVES: The aim of the study was to assess the compliance of adolescents in the field of pharmacological and non-pharmacological methods of hypertension treatment. MATERIAL AND METHODS: The study included 62 patients (20 women, 42 men) diagnosed with hypertension and treated in specialist healthcare facilities. As a research tool, a questionnaire prepared on the basis of recent literature was used. RESULTS: The vast majority of respondents (72.7%) declared that they were regularly taking antihypertensive drugs. The proportion of patients regularly taking antihypertensive drugs was higher in patients treated with monotherapy than with polytherapy (48.5% vs. 24.2%). Among the methods of non-pharmacological treatment of hypertension, the most accepted lifestyle change in the study population was smoking cessation (83.8% of respondents) and reduction of salt consumption (64.5% of respondents), and the least acceptable lifestyle change was maintaining proper body weight by eating a low calorie diet (30.6% of respondents). CONCLUSIONS: Adolescents with hypertension adhere in varying degrees to medical recommendations related to the hypertension treatment. The available literature indicates that the currently effective way to improve cooperation with the patients is education.

Economic aspects of hypertension treatment in Poland.

INTRODUCTION: The aim of this study was to assess the costs associated with mild hypertension (HTN) in Poland and to compare the costs of 3-year ambulatory care for those diagnosed with mild HTN (group A) and those diagnosed with mild HTN and comorbidities (group B). MATERIAL AND METHODS: The researchers undertook a retrospective study of a group of 120 patients treated for 3 years (2006-2008) (60%, n = 72 women and 40%, n = 48 men), taking into account the broadest possible social perspective. Medical and non-medical direct costs as well as indirect costs were calculated. RESULTS: The total costs of the 3-year pharmacotherapy in group A equalled 49,985.65 EUR, or 833.09 EUR per patient, whereas in group B the costs were twice as high: 105,691.55 EUR in total or 1,761.53 EUR per patient. Indirect costs for group A patients totalled 3,468.80 EUR (578.13 EUR per patient) and 4,579.20 EUR for group B patients (572.40 EUR per patient). Total direct costs (medical and non-medical) and indirect costs for group B patients were much higher, amounting to 130,228.14 EUR and 2,666.55 EUR per patient, which was double the costs in group A, where costs were 74,184.96 EUR and 1,756.73 EUR per patient. CONCLUSIONS: The costs of HTN treatment in Poland are very high and are growing, like in other countries. Potential solutions include developing better patientdoctor communication to improve compliance, and increasing the chances of more effective and less expensive therapy by prescribing cheaper generic drugs, limiting polypharmacy and improving availability of novel therapeutic methods.

Comparative studies on promotion of health and life style of hospital staff in Sweden and Poland.

INTRODUCTION: Recently, an increase has been observed in the number of patients suffering from diseases which are the consequence of an anti-health life style; therefore it is necessary to undertake proper actions in this area, including those addressed to hospital staff. OBJECTIVES: 1) Comparison of self-reported state of health and life style between hospital staff in Sweden and Poland, and the motivation of these employees to change the to-date life style for one that is more health promoting. 2) Presentation, based on Swedish experiences in the field of health promotion in hospitals, of the possibilities to implement these changes in Polish conditions. MATERIAL AND METHOD: The study covered the staff from the following hospitals: 1) hospitals in Östergötland County, Sweden, and 2) the Ludwik Perzyna Regional Polyclinical Hospital in Kalisz, Poland. The studies were conducted in parallel in Sweden and in Poland during the fourth quarter 2010. The research instrument was a questionnaire form. RESULTS: The following measures should be undertaken by the staff of Polish hospitals: an increase in the consumption of fruit and vegetables, physical activity, organization of workshops aimed at the shaping of skills of coping with stress and relieving stress, assistance in reducing body weight and increasing physical activity. Obligatory breaks at work should be introduced for the consumption of meals and intake of beverages, including water, promotion of fluid replacement would reduce fatigue. An obligatory lunchtime would allow each employee to consume a decent meal, and consequently have respite away from one's own work activities. In order to have a well-functioning staff an employer should, in his/her own interest, decrease potential sick absenteeism, provide incentives for motor activity, e.g. by the organization of groups, reduction of weekly working time on behalf of documented physical activity, or financial support for the purchase of tickets for various forms of physical exercises. Promotion of collective exercise, e.g. common nordic walking for 30 min. during lunch, competition in the largest number of steps made. Promotion of healthy nutrition by the preparation of recipes for meals, several exemplary healthy meals in the form of a healthy alternative breakfast. During this event, a basket of fruit is provided, instead of cakes and sweets. CONCLUSIONS: 1) The life style of the staff of health care facilities is more health promoting in Sweden than in Poland. 2) It is possible to change the life style of employees of health care facilities into one that is more health promoting. Changes in this area have been made in Sweden with a great success; therefore, it is worthwhile implementing in Poland these Swedish experiences which may function also in Polish conditions. 3) The foundations of health promotion in enterprises have been known for a long time; however, considering the fact that the comparative studies show that these foundations are more advanced in Sweden, it is necessary that Polish employers devote more attention to this problem, and become interested in Swedish experiences in this area.

[Expression of chemokine receptor CCR5 in patients with type 2 diabetes]. / Ocena ekspresji receptora chemokinowego CCR5 u chorych na cukrzyce typu 2.

UNLABELLED: Overexpression of chemokine receptors might contribute to the initiation of atherosclerosis, due to promotion of monocyte migration to the subendothelial space which is considered as an initiating mechanism in the natural history of atherosclerosis. The CCR5 receptor is one of the chemokine receptors present on peripheral T lymphocytes, monocytes and macrophages. OBJECTIVE: The aim of the study was to determine the expression of CCR5 receptor on peripheral blood mononuclear cells (PBMC) in patients with type 2 diabetes. MATERIAL AND METHODS: 14 patients with type 2 diabetes and 6 healthy subjects as a control were included to the study. We evaluated the density of the CCR5 receptor on peripheral blood mononuclear cells by flow cytometric analysis by use of LSR Cytofluorograf System (Becton Dickinson Co.). RESULTS: There was significantly higher density of the CCR5 receptor on PMBC in diabetic subjects when compared to the controls. CONCLUSIONS: (1) Patients with type 2 diabetes present overexpression of the CCR5 receptor on peripheral blood mononuclear cells. (2). Overexpression of the CCR5 receptor should be considered as a factor that promotes the development of atherosclerosis in diabetic patients.