Associations Between Mean Platelet Volume and Various Factors in Type 2 Diabetes Patients: A Single-Center Study from Poland.

BACKGROUND Thromboembolic episodes, which are largely mediated by blood platelets, are prevalent chronic complications of diabetes. The mean platelet volume (MPV) serves as a marker for in vivo platelet activation. This study aimed to assess the factors influencing MPV in 106 patients with type 2 diabetes, compared with 59 non-diabetic individuals at a single center in Poland. MATERIAL AND METHODS We performed linear regression analysis, with MPV as the dependent variable and factors such as age, sex, thrombopoiesis-influencing cytokines, blood pressure, body mass index, glycosylated hemoglobin percentage, platelet count, large platelet count, lipid profile parameters, creatinine concentration, estimated glomerular filtration rate, treatment modalities, and comorbidities as independent variables. MPV was measured using the ADVIA 2120 hematology analyzer, with a reference range of 7-12 fL. RESULTS The analysis revealed that in patients with type 2 diabetes, an increase in platelet count by 10×10³/µL resulted in a decrease in MPV by 0.05 (P<0.001), while an increase in large platelet count by 1×10³/µL led to an increase in MPV by 0.18 (P<0.001). Additionally, patients taking ß-blockers or insulin had lower MPVs by 0.77 (P=0.008) and 5.63 (P<0.001), respectively, compared with those not on these medications. CONCLUSIONS This study delineates the relationship between MPV, platelet parameters, and treatment modalities in type 2 diabetes, paving the way for further research to elucidate underlying mechanisms and potential clinical applications.

Analysis of Parents' Attitudes and Knowledge toward Immunization and How These Factors Influence Their Decisions to Vaccinate Their Children against Human Papilloma Virus (HPV).

Background and objectives: Vaccination hesitancy is a growing problem associated with decreasing chances for the elimination of vaccine-preventable diseases through immunization. This research was conducted to learn about parents' attitudes toward vaccination, particularly against HPV, in the context of their beliefs and fears regarding immunization and the impact of these views on their children's vaccination decisions. An additional goal was to determine what views or convictions most often lead to the phenomenon of delaying or refusing vaccinations, especially HPV vaccines, in the surveyed community. Materials and Methods: An online questionnaire was conducted in which parents marked how they vaccinated their children with mandatory vaccinations and whether they took the opportunity to protect their children with additional vaccinations, including HPV and COVID-19. Respondents also marked the extent to which they agreed with the statements, regarding the safety of vaccinations, doubts about them, as well as popular anti-vaccine myths. Results: A total of 250 questionnaires were collected with data on the immunization of 425 children. Associations between specific beliefs and vaccine abstention were established. The most motivating factor for vaccination against HPV was the parent's awareness that the virus HP is the cause of cancer. The most inhibiting factor was respondent's compliance with the opinion that HPV vaccines can affect the child's sexual activity. Conclusions: The results indicate that information campaigns are needed, especially focusing on vaccine safety and the regularity and transparency of monitoring adverse effects. The obtained results will be used to create educational interventions against vaccination hesitancy more adapted to local conditions.

Long-Term Outpatient Care and Rehospitalizations in Patients after Cardiac Electrotherapy Device Implantation.

Background and Objectives: Cardiovascular implantable electronic device (CIED) treatment is widely used in modern cardiology. Indications for this type of treatment are increasing. However, a significant proportion of CIED implantation patients require subsequent hospitalization for cardiovascular reasons. Older age and the associated complex clinical picture necessitate multidisciplinary outpatient specialist care for these patients. The aim of this study was to analyze the reasons for subsequent hospitalizations in the cardiology department and the impact of outpatient specialty care on these hospitalizations. To the best of our knowledge, there are no such studies in the available literature. Materials and Methods: This study was conducted on a population of patients treated with CIED. Reasons for subsequent hospitalizations were divided into clinically and statistically valid groups according to the main diagnosis. Using an electronic database, causes of hospitalization were determined based on this diagnosis. Using data on consultations at outpatient specialty clinics, a logistic regression model was created for the probability of subsequent hospitalization for cardiovascular causes according to the specialty of the clinic. Results: The 9-year follow-up included a population of 2071 patients treated with CIED. During the follow-up period, 508 patients (approximately 24.5%) required subsequent hospitalization for cardiovascular reasons. The most common leading causes were heart failure, atrial fibrillation, and coronary artery disease. The need for consultation at outpatient specialty clinics increased the likelihood of hospitalization. Moreover, the need to consult patients in nephrology outpatient, pulmonary disease outpatient, and orthopedic outpatient clinics was the most significant. Conclusions: The use of electronic implantable cardiovascular devices is a very important part of therapy in modern cardiology. The methods for their use are constantly being improved. However, they represent only one stage of cardiac treatment. After CIED procedures, patients require further care in both inpatient and outpatient specialty care settings. In this paper, we outline the reasons for subsequent hospitalizations and the importance of outpatient specialty care in this context. Effective organization of care after CIED procedures may be important in reducing the most expensive component of this care, that is, inpatient treatment.

Could IL-1ß, IL-6, IFN-γ, and sP-selectin serum levels be considered as objective and quantifiable markers of rheumatoid arthritis severity and activity?

Objectives: Rheumatoid arthritis (RA) is a multisystem, chronic, T-cell-mediated disease in which immunological abnormalities result in symmetrical small joint inflammation, articular destruction due to synovitis, and extra-articular organ involvement. An important role in the pathogenesis of RA is attributed to a combination of genetic factors and environmental triggers. Literature data on the utility of circulating IL-1ß, IL-6, IFN-γ, and sP-selectin concentration evaluation depending on the activity and advancement of RA seems to be inconclusive. The aim was a case-control study evaluating IL-1ß, IL-6, IFN-γ, and sP-selectin concentrations in 77 RA patients dependent on the Steinbrocker classification as well as the disease activity score with examination of 28 joints (DAS28), and compared to 30 control subjects. Material and methods: Serum IL-1ß, IL-6, IFN-γ, and sP-selectin concentrations were measured using ELISA kits. Results: The concentrations of all molecules tested, except for IL-1ß, were significantly different from the control group. Univariate logistic regression analysis indicated that their levels significantly influenced the likelihood of RA diagnosis. Differences between IL-1ß, IL-6, IFN-γ, and sP-selectin concentrations dependent on the disease activity assessed on the basis of the DAS28 score, as well as the severity of the disease assessed based on the Steinbrocker classification, were not observed. IL-6 positively correlated with the DAS28 score. Conclusions: Among the tested molecules, only IL-6 positively correlated with the DAS28 score. Thus, we postulate that next to C-reactive protein and the erythrocyte sedimentation rate, also IL-6 could be clinically relevant and possibly reflects RA activity. Because recently the IL-6 concentration can be determined in applied in vitro diagnostic tests, it presents us with the possibility to test this protein as a marker of RA activity in routine laboratory practice.

Serum fatty acid binding protein 5 (FABP5) as a potential biomarker of inflammation in psoriasis.

Fatty acid binding protein 5 (FABP5) is elevated in psoriatic keratinocytes and could be involved in systemic metabolic disturbances in psoriasis. The aim of the study was to evaluate serum FABP5 in obese and non-obese psoriatic patients, to assess the relationship between FABP5 and the duration, severity of the disease, inflammatory and metabolic markers and influence of treatment with narrowband-ultraviolet B (NB-UVB). Seventy-four patients (30 treated with NB-UVB) with psoriasis were enrolled in the study. The serum concentrations of FABP5 were measured using Human FABP5 Enzyme-Linked Immunosorbent Assay kit. Serum fatty acids were measured by gas-liquid chromatography. Serum FABP5 levels in psoriatic patients were higher versus control group (P < 0.001). FABP5 in patients with PASI > 20 was higher compared to the mild group (PASI < 10) (P < 0.001) and serum FABP5 correlated positively with PASI score (r = 0.41, P < 0.001). There was also positive correlation between FABP5 and basic inflammation indices. Decrease of PASI after NB-UVB treatment (P < 0.001) was observed and accompanied by decrease of the serum FABP5 (P = 0.007). FABP5 is a potential marker of psoriasis, its severity and clinical outcome after therapy with NB-UVB. FABP5 may reflect metabolic disturbances in psoriatic patients.

Long-Term, Single-Centre Observation of Patients with Cardiac Implantable Electronic Devices.

Background and Objectives: Electrotherapy is a valuable treatment method for patients with heart rhythm disturbances. There are very few observations of long-term patients treated with these techniques. There is a particular lack of this type of study conducted in Eastern European countries. The aim of this single-centre analysis was to evaluate the long-term survival (from 2010 to 2018) of patients treated with electrotherapy devices, taking into account clinical factors facilitating the prognosis of these patients. Materials and Methods: The patients (N = 2071) subsequently included in the study were subjected to the implementation or replacement of cardiac pacemakers. The medical records of all the patients were analysed. Data concerning death, made available by the State Systems Department of the Ministry of Administration and Digitization, were used. Results: The patients with VVI pacemakers had the worst prognosis after the replacement of the devices. Male patients had a worse prognosis, regardless of the kind of device implanted. Advanced atrioventricular conduction disturbances, chronic kidney disease, and hypothyroidism with reduced left ventricular ejection fraction were among the most significant coexisting diseases. Conclusions: The long-term prognosis of patients under different forms of electrotherapy remains poor. Despite the more straightforward technique, a single-chamber device (VVI/AAI) or generator replacement leads to the worst prognosis. The complexity of the clinical picture that stems from coexisting diseases and advanced age is of the utmost importance.

Lipid profile disturbances may predispose psoriatic patients to liver dysfunction.

INTRODUCTION: Psoriasis is a chronic inflammatory disease associated with metabolic disturbances and liver dysfunction. Both serum fatty acids (FA) and ceramides (Cer) have structural functions but also are signal molecules that could be involved in the pathogenesis of liver dysfunction. AIM: To assess the concentration of the circulating FA and Cer in correlation with the alanine aminotransferase (ALT) blood level in psoriatic patients. In addition, we have examined the relationship between ALT concentration and severity of the disease and inflammation markers. MATERIAL AND METHODS: Eighty-five patients with psoriasis and 32 healthy controls were enrolled in the study. Patients were divided into 2 groups according to ALT blood levels. Serum concentration of 14 FA and 14 Cer were measured by gas-liquid chromatography. The results were correlated with the Psoriasis Area and Severity Index (PASI), serum lipid profile, and inflammatory markers. RESULTS: We observed higher PASI score (p = 0.01) and higher C-reactive protein (p = 0.02) concentration in the group of psoriatic patients with high ALT. Serum ALT positively correlated with saturated fatty acids (SFA) (p = 0.01, r = 0.27) and SFA/unsaturated fatty acids (UFA) ratio (p = 0.01, r = 0.26). ALT negatively correlated with UFA level (p = 0.008, r = -0.28). Lignoceric ceramide positively correlated with ALT level (r = 0.22; p = 0.045) in psoriatic patients. CONCLUSIONS: Patients with severe psoriasis are predisposed to the development of liver dysfunction. We have demonstrated disturbances of serum fatty acid and sphingolipid profile in psoriatic patients, which may trigger liver disease.

Serum and cerebrospinal fluid Neudesin concentration and Neudesin Quotient as potential circulating biomarkers of a primary brain tumor.

BACKGROUND: Despite the previously suggested role of Neudesin in tumorigenesis and its potential as a novel target for the treatment of cancers, its prognostic value has never been examined. Thus, the aim of the study was to evaluate Neudesin concentrations in primary brain tumor patients and make a comparison with non-tumoral individuals. METHODS: Cerebrospinal fluid (CSF) and serum Neudesin concentration was evaluated by means of the ELISA method. RESULTS: The total group of brain tumor patients had statistically lower serum Neudesin concentrations compared to the non-tumoral group (P = 0.037). The meningeal tumor subgroup also had statistically lower serum Neudesin concentrations compared to the non-tumoral group (P = 0.012). The Astrocytic brain tumor subgroup had significantly higher CSF Neudesin concentrations compared to the non-tumoral group (P = 0.046). Neudesin Quotient (CSF concentration divided by serum concentration) in the astrocytic brain tumor subgroup was statistically higher compared to the non-tumoral group (P = 0.023). Males had statistically lower concentrations of the serum Neudesin compared to females (P = 0.047). Univariate linear regression analysis revealed that for women the serum Neudesin concentration was 1.53 times higher than for men. In the model of multivariate linear regression analysis, predictor variables influencing serum Neudesin concentrations included CSF Neudesin concentration and the Neudesin Quotient, if other model parameters are fixed. The developed model explains 82% of the variance in serum Neudesin concentration. Both linear regression models, univariate and multivariate, pointed to fewer factors with a potential to influence the Neudesin Quotient compared to serum Neudesin concentration. CONCLUSIONS: In astrocytic brain tumor patients Neudesin concentrations within the cerebrospinal fluid are higher compared with non-tumoral individuals. Serum Neudesin concentration strongly correlates with its CSF level. In primary brain tumor patients serum Neudesin concentration is clearly gender-dependent. Linear regression models pointed to fewer factors that may influence the Neudesin Quotient value, which suggests it is a better biomarker of astrocytic brain tumors than serum and CSF Neudesin concentrations alone.

Patients with respiratory tract infections who do not want antibiotics: direct observational study of primary care in Poland.

BACKGROUND: Requests by patients for antibiotics are known to strongly affect doctors' decisions to prescribe them.Objective. The aim of this study was to establish how frequently patients presenting with respiratory tract infections (RTIs) express their expectation not to be treated with antibiotics, which symptoms and physical findings are related to their perception of antibiotics not being helpful, and to what degree their expectations influence doctors' decisions. METHODS: This was a direct observational study set in primary care practices in Bialystok, Poland. The observers completed a checklist while observing a patient with RTI visiting a family doctor. RESULTS: Overall, 80 (5.5%) out of 1456 patients with RTIs openly requested not to be prescribed antibiotics. Patients not wanting antibiotics were prescribed antibiotics significantly less frequently [25/80 (31.3%)] than the remaining patients [765/1376 (55.6%), P < 0.001]. Univariate logistic regression revealed that cough and runny nose significantly increased the odds of patients not wanting antibiotics [odds ratio (OR) 1.8, 95% confidence intervals (CI): 1.01-3.20 and OR 1.6, 95% CI: 1.01-2.6, respectively] while the presence of tonsillar exudates significantly decreased the odds (OR 0.3, 95% CI: 0.08-0.86). Belief in a self-limited course (20%), recent treatments with antibiotics (16.3%), suspected viral aetiology (12.5%), and concerns about possible harm (12.5%) were the principal reasons for not wanting antibiotics. CONCLUSIONS: A patient's wish not to be prescribed antibiotics leads to less frequent antibiotic prescribing. Antimicrobial resistance, though important from a public health viewpoint, is not seen as a priority for individual patients with infections.

Serum sphingolipid level in psoriatic patients with obesity.

INTRODUCTION: Psoriasis is a chronic inflammatory disease associated with metabolic syndrome, including obesity. Ceramides (CER) and sphingosine-1-phosphate (S1P), which belongs to sphingolipids, have both biological and structural functions in the human epidermis. AIM: To evaluate serum concentrations of selected CER in psoriatic patients in different weight ranges, the impact of obesity on the concentration of circulating CERs, their association with the course of psoriasis and selected inflammatory markers. MATERIAL AND METHODS: Eigthy-five patients with active plaque-type psoriasis and 32 healthy controls were enrolled in the study. Patients were divided into 3 groups: normal weight, overweight and obese. Serum concentrations of 14 ceramides were measured by gas-liquid chromatography. The results were correlated with the Psoriasis Area and Severity Index (PASI), serum lipid profile and inflammatory markers. RESULTS: There were no significant differences in total serum CER concentration between psoriatic groups of patients. The S1P concentration was higher in psoriatic patients with normal body weight and overweight than in the control group (p = 0.002 and p = 0.04, respectively). In psoriatic patients with normal body weight, nervonic ceramide (C24:1) correlated with PASI (r = 0.38; p = 0.042) and CRP (C-reactive protein) (r = 0.42; p = 0.023). In overweight patients, the concentration of lignoceric ceramide (C24:0) correlated inversely with the severity of the disease (r = -0.41; p = 0.022) and CRP (r = -0.6; p = 0.0004). CONCLUSIONS: We have demonstrated an abnormal sphingolipid profile in psoriatic patients in different weight groups. Selected CER might be the biomarkers of psoriasis severity and inflammation, may reflect lipid disturbances and contribute to the development of metabolic syndrome.

Artificial Mucin-based Saliva Preparations - Physicochemical and Tribological Properties.

PURPOSE: To create and investigate artificial mucin-based saliva substitutes with properties similar to natural saliva. MATERIALS AND METHODS: Natural saliva and six saliva preparations were tested. Saliva substitutes were made using phosphate buffered saline (PBS) prepared in deionised water or plasma-treated water (PBSPT) with addition of porcine gastric mucin and guar gum or poloxamer 407. A wide range of properties were characterised: physicochemical (changes of pH, conductivity and surface tension over time: 1, 24, 96, 168 h after mixing ingredients), rheological (viscosity and viscoelasticity), tribological (coefficient of friction for titanium alloy Ti-6Al-7Nb kinematic couple) and corrosive (open circuit potential, corrosion potential, polarisation resistance). RESULTS: Saliva preparations based only on mucin had pH, viscosity, coefficient of friction and corrosion parameters similar to those of natural saliva. Guar gum increased the values of viscosity, viscoelasticity and the coefficient of friction. Similar results were obtained for poloxamer 407, whereas it decreased the surface tension of tested preparations. Plasma-treated PBS enhanced the corrosion resistance of saliva substitutes with guar gum and poloxamer 407. CONCLUSION: Among the tested compositions, saliva substitutes based only on mucin were found to have parameters similar to human whole saliva. Mucin saliva preparations may have wide applicability for patients with e.g. xerostomia or patients using a metal prosthesis.

Epidemiological characteristics of patients with syphilis in Gdansk and Warsaw in 2016

INTRODUCTION: Syphilis is a systemic disease with a complex natural history and a diversified clinical symptomology, taking various forms. It is characterized by a long-term course, often asymptomatic. The Global Estimates indicate that Treponema pallidum caused 5.6 million infections per year. AIM: Epidemiological characteristics of patients with syphilis in selected Polish urban agglomerations (Warsaw and Gdansk) in 2016. MATERIAL AND METHODS: Cases of syphilis reported by doctors to The Provincial Sanitary and Epidemiological Stations in Gdansk (50 cases) and in Warsaw (520 cases) in 2016 were analysed. RESULTS: The average age of patients with syphilis was 35.2 years (Me=32 years). Men were more likely to suffer from syphilis - 493 cases (ie. 86.5%). The probable transmission route of the infection was indicated in 45% of cases and in 7.9% (45 people) it was undetermined sexual contact, in 11.6% (66 people) - heterosexual contact, and in 24.4% (139 people) - homosexual contact. In 7 cases (ie 1.2%), the infection was transferred vertically. A statistically significant relationship was found between the route of infection and the sex of the infected person (p<0.01). The incidence of individual syphilis forms was significantly different between the examined cities (p<0.01). DISCUSSION: The group of people suffering from syphilis described in the study reflects the population of young people, especially men, living in urban agglomerations, characterized by mobility, considered the group most at risk of STI/ STD. The male-to-female rate among the respondents was 6.4:1 and was similar to the overall rate in Europe in 2014, ie 6.2:1. Number of cases of early syphilis (39.5% of all reports in Warsaw and 80% in Gdansk) may suggest insufficient detection of infections in Gdansk and the need to intensify syphilis screening. In 2014, there were 69 cases of congenital syphilisn in the EU / EEA, of which every fourth newborn was born in Poland (n = 17). CONCLUSION: The latent syphilis form acquired mainly through heterosexual contacts has dominated among women suffering from syphilis. Amidst men syphilis was diagnosed mainly in the primary stage of infection and was most commonly acquired as a result of homosexual relationships. The epidemiological situation in Poland of syphilis, has been influenced by infections among MSM.

Correlation between electronic structure, transport and electrochemical properties of a LiNi1-y-zCoyMnzO2 cathode material.

Herein, the correlation between electronic structure, transport and electrochemical properties of layered LixNi1-y-zCoyMnzO2 cathode material is revealed. Comprehensive experimental studies of physicochemical properties of LixNi1-y-zCoyMnzO2 cathode material (XRD, electrical conductivity, thermoelectric power) are supported by electronic structure calculations performed using the Korringa-Kohn-Rostoker method with the coherent potential approximation (KKR-CPA) to account for the chemical disorder. It is found that even small O defects (∼1%) could significantly modify electronic density of states DOS characteristics via the formation of extra broad peaks inside the former band gap leading to its substantial narrowing. The calculated DOS values and their changes near EF tend to support experimental findings with irregular changes in the sign of thermoelectric power as well as the behavior of electrical conductivity curves as a function of Li content. Furthermore, the variations of the electromotive force of the Li/Li+/LixNi1-y-zCoyMnzO2 cell (for 0 < x < 1) remains in a quite good agreement with the relative variation of EF on DOS calculated from the KKR-CPA method.

Combined assessment of clinical and patient factors on doctors' decisions to prescribe antibiotics.

BACKGROUND: Antibiotic overprescription is a worldwide problem. Decisions regarding antibiotic prescription for respiratory tract infections (RTIs) are influenced by medical and non-medical factors. METHODS: In family medicine practices in Bialystok, Poland, family medicine residents directly observed consultations with patients with RTI symptoms. The observing residents completed a questionnaire including patient data, clinical symptoms, diagnosis, any prescribed antibiotic, and assessment of ten patient pressure factors. RESULTS: Of 1546 consultations of patients with RTIs, 54.26 % resulted in antibiotic prescription. Antibiotic prescription was strongly associated with rales (OR 26.90, 95 % CI 9.00-80.40), tonsillar exudates (OR 13.03, 95 % CI 7.10-23.80), and wheezing (OR 14.72, 95 % CI 7.70-28.10). The likelihood of antibiotic prescription was increased by a >7-day disease duration (OR 3.94, 95 % CI 2.80-5.50), purulent nasal discharge (OR 3.87, 95 % CI 2.40-6.10), starting self-medication with antibiotics (OR 4.11, 95 % CI 2.30-7.30), and direct request for antibiotics (OR 1.87, 95 % CI 1.30-2.80). Direct request not to prescribe antibiotics decreased the likelihood of receiving antibiotics (OR 0.34, 95 % CI 0.27-0.55). CONCLUSION: While clinical signs and symptoms principally impact prescribing decisions, patient factors also contribute. The most influential patient pressure factors were starting self-medication with antibiotics, and directly requesting antibiotic prescription or no antibiotic prescription. Interventions aiming to improve clinical sign and symptom interpretation and to help doctors resist direct patient pressure could be beneficial for reducing unnecessary antibiotic prescribing.

Do morphokinetic data sets inform pregnancy potential?

PURPOSE: The aim of this study was to create a model to predict the implantation of transferred embryos based on information contained in the morphokinetic parameters of time-lapse monitoring. METHODS: An analysis of time-lapse recordings of 410 embryos transferred in 343 cycles of in vitro fertilization (IVF) treatment was performed. The study was conducted between June 2012 and November 2014. For each embryo, the following data were collected: the duration of time from the intracytoplasmic sperm injection (ICSI) procedure to further division for two, three, four, and five blastomeres, time intervals between successive divisions, and the level of fragmentation assessed in successive time-points. Principal component analysis (PCA) and logistic regression were used to create a predictive model. RESULTS: Based on the results of principal component analysis and logistic regression analysis, a predictive equation was constructed. Statistically significant differences (p < 0.001) in the size of the created parameter between the implanted group (the median value: Me = -5.18 and quartiles: Q 1= -5.61; Q 3 = -4.79) and the non-implanted group (Me = -5.69, Q 1 = -6.34; Q 3 = -5.16) were found. A receiver operating characteristic (ROC) curve constructed for the considered model showed the good quality of this predictive equation. The area under the ROC curve was AUC = 0.70 with a 95% confidence interval (0.64, 0.75). The presented model has been validated on an independent data set, illustrating that the model is reliable and repeatable. CONCLUSIONS: Morphokinetic parameters contain information useful in the process of creating pregnancy prediction models. However, embryo quality is not the only factor responsible for implantation, and, thus, the power of prediction of the considered model is not as high as in models for blastocyst formation. Nevertheless, as illustrated by the results of this study, the application of advanced data-mining methods in reproductive medicine allows one to create more accurate and useful models.

Clinical and epidemiological assessment of patients hospitalized for primary and recurrent erysipelas / Ocena kliniczna i epidemiologiczna pacjentów hospitalizowanych z powodu rózy pierwotnej i nawrotowej

INTRODUCTION: Erysipelas is a bacterial infection, caused by group A ß-hemolytic streptococci (Streptococcus pyogenes), rarely other bacteria. It is characterized by sudden onset and rapid course, with the presence of systemic symptoms. OBJECTIVE: A retrospective analysis of patients hospitalized for primary and recurrent erysipelas with particular consideration of clinical profile of patients, causes, complications and risk factors of the recurrence. MATERIAL AND METHODS: We have analyzed the medical records of patients hospitalized for erysipelas at the Dermatology and Venereology Department of the Medical University of Bialystok from 2011 to 2015. RESULTS: One hundred twenty female (53,8%) and 103 male (46,2%) were included in the study. The median age was 61. The first episode of clinical symptoms was observed in 78% patients, while 22% of them were diagnosed as recurrent erysipelas. Skin lesions in both cases were located in the lower extremities most often. Mechanical trauma was statistically more frequently cause of the disease in men, while venous insufficiency and ulcers in women. Complications such as abscess, ulceration, phlegmon and thrombosis were observed in 22% of patients, significantly more common in men. Patients who were hospitalized more than 10 days were more likely to have higher body mass index and higher indicators of inflammation than patients who required a shorter hospital stay. Recurrent erysipelas was more often diagnosed in patients with co-morbidities, including hypertension, overweight, venous insufficiency and diabetes. CONCLUSIONS: Erysipelas located in the lower extremities, high temperature on admission, higher indicators of the inflammation, complications and coexistence of obesity and diabetes are the risk factors of the prolonged hospital stay. Primary and recurrent erysipelas have a similar course, severity of the disease and duration of hospitalization.

[Vitamin D deficiency in psoriatic patients in north-east of Poland].

Background: Recent studies point out the important role of vitamin D in the pathogenesis of many autoimmune diseases, in between psoriasis. Vitamin D regulates function of the dendritic cells, proliferation and maturation of the keratynocytes and lymphocytes T. The aim of the study was to evaluate serum vitamin D (25OHD) concentrations in psoriatic patients in the north-east of Poland and their comparison in the summer and winter period of the year. We also evaluated relationship between 25OHD concentration and disease severity, prevalence of psoriatic comorbidities and laboratory results. Material and Methods: 25OHD serum concentration was evaluated by electrochemiluminescent method in 115 patients with exacerbated plaque type psoriasis. 39 patients were evaluated in the summer and 79 in the winter time. 28 patients from winter group were treated with narrow band ultraviolet B radiation (NB-UVB). The results were compared with 38 healthy persons. Results: 25OHD serum concentrations of psoriatic patients were significantly lower than in the control group (p=0,0003). Vitamin D deficiency was diagnosed in 66% of patients in the summer time and in 63% in winter time; in the control group: 24% during the summer and 71% during the winter. After UVB phototherapy we observed reduction of skin lesions, measured as a significant decline in the Psoriasis Area and Severity Index (PASI) (p<0.001). The serum 25OHD concentration increased (p<0.001). After the treatment 65% of the psoriatic patients reached normal range of 25OHD concentration, 35% of patients were still vitamin D insufficient. We demonstrate positive correlation between increase in 25OHD and number of NB-UVB phototherapy sessions (r=0.38). Conclusions: We have observed vitamin D deficiency both in psoriatic patients and in the control group. Among psoriatic patients the praevalence of deficiency were higher than in the control group, especially during the summer months. Frequent vitamin D defficiency in the groups studied indicates the need of for its supplementation. The 25OHD serum concentrations increased after phototherapy with UVB.

Decreased CD127 expression on CD4+ T-cells and elevated frequencies of CD4+CD25+CD127- T-cells in children with long-lasting type 1 diabetes.

Pathobiology of type 1 diabetes (T1D) is predominantly associated with T-cell-related actions. Homeostasis of majority of T-cells is critically dependent on signals mediated by CD127 (interleukin-7 receptor, IL-7R). In contrast, regulatory T-cells express very little CD127 and thereby may be delineated by CD4+CD25+CD127- phenotype. Here we aimed to analyze CD127 expression on CD4+ and CD8+ T-cells and enumerate CD4+CD25+CD127- T-cells in long-lasting T1D. T-cells were analyzed by flow cytometry and immunologic data were correlated with vascular, metabolic, and inflammatory parameters. We demonstrated significantly decreased CD127 levels on CD4+, but not CD8+, T cells in T1D pediatric patients. Interestingly, frequencies of CD4+CD25+CD127- T-cells were significantly enhanced in T1D children and correlated well with frequencies of CD34+CD144+ endothelial progenitor cells and CD4+CD25- T-cells. Levels of CD127 on both CD4+ and CD8+ T-cells in T1D patients were not correlated to each other or HbA1C. Interestingly, however, CD127 levels on CD4+ T-cells were significantly correlated to frequencies of CD4+CD25+CD127- T-cells, whereas CD127 levels on CD8+ T-cells were significantly correlated to concentrations of VEGF and triglycerides. Our data indicate that CD127 expression is differentially modulated on CD4+ and CD8+ T-cells in the course of T1D. Moreover, we demonstrated that, in contrast to recent-onset T1D, long-lasting T1D is associated with enhancement of T-cells with regulatory phenotype.

[Analysis of the demographic profile of patients treated for infertility using assisted reproductive techniques in 2005-2010]. / Analiza profilu demograficznego pacjentów leczonych z powodu nieplodnosci metodami rozrodu wspomaganego w latach 2005-2010.

OBJECTIVES: Analysis of the demographic profile of patients, causes for infertility and effectiveness of infertility treatment methods in the years 2005-2010. MATERIAL AND METHODS: Retrospective research was conducted to analyze data of 1705 randomly selected couples who underwent in vitro fertilization procedure at the Department of Reproduction and Gynecological Endocrinology Medical University of Bialystok, between 2005 and 2010. The analyzed data included mainly causes for infertility age of the female and male subjects, place of residence and final treatment results. RESULTS: The percentage of pregnancy rate increased significantly to approximately 40% in 2007. The contribution of male and female infertility factors remained at a similar level, but the idiopathic factor continued to steadily increase (to 20% in the last years of the study). We observed a greater prevalence of the male factor among couples living in cities compared to inhabitants of rural areas (42.3% vs. 34.3%, p = 0.004), whereas the tubal factor dominated among couples living in the countryside when compared to city dwellers (29.7% vs. 21.6%, p = 0.001). The average age of women entering treatment was significantly higher in cities than the countryside (p < 0.001), thus, consequently treatment efficacy was also lower (33.9% vs. 38.9%, p = 0.04). Comparison of treatment efficacy and cause of infertility revealed statistically significant differences only with regard to the idiopathic factor (p = 0.03). In the group of patients with idiopathic infertility the treatment efficacy was higher than in the rest of patients (40.2% vs. 33.8%). Apart from the idiopathic infertility only the presence of the male factor was associated with a higher (but statistically insignificant) pregnancy rate (36.2% vs. 33.9%). For the other factors, their presence was associated with a lower percentage of pregnancy and the greatest differences (but still statistically insignificant) were observed for the polycystic ovary syndrome (31.5% vs. 35.1%) and for other ovulation disorders (31.3% vs. 35%). CONCLUSIONS: Advances in assisted reproductive techniques led to an increase in the efficacy of infertility treatment. Environmental factors, availability of treatment and level of awareness about womens health proved to have the strongest effect on the distribution of infertility causes between urban and rural areas. Significant efforts should be made, especially in cities, to decrease the average age of women's reproductive decisions and also to shorten the time to the first contact with the specialist after unsuccessful attempts at conception. It is also crucial to initiate the reimbursement of infertility treatment using ART (Assisted Reproductive Technology).

Comparison between the American and the European Systems of Monitoring Adverse Effects of Dietary Supplements and Their Usefulness on the Polish Market.

Many Polish patients do not inform physicians about supplements they use in addition to prescribed medicines. This may be because they consider dietary supplements as being rather natural products that cannot cause health problems. Although dietary supplements may produce side effects, Poland's food safety system and medical statistics do not recognise the necessity of reporting such cases. However, a different approach is observed in France and the United States where adverse effects of food supplements as well as drugs are reported. The aim of this study was to determine the need for creating in Poland a general model of a register monitoring dietary supplements and their adverse effects. In order to achieve this goal, a detailed comparison between the American and European monitoring systems was made. It showed the relationship between negative symptoms caused by specific components in supplements and t profiles of patients who reported side effects. Additionally, it was found that there is a real risk associated with side effects caused by dietary supplements. Therefore, it necessary to establish in Poland a special system for recording such cases as it should be beneficial to patients, including polypragmatic patients.