Prevalence of diabetes in Poland: a combined analysis of national databases.

AIMS: To assess the number of people with diabetes in Poland using combined national sources and to evaluate the usefulness of data from an insurance system for epidemiological purposes. METHODS: The data were collected from four sources: 1) 2013 all-billing records of the national insurance system comprising people of all age groups undergoing procedures or receiving services in primary healthcare, specialist practices and hospitals and also those receiving drugs; 2) an epidemiological study, NATPOL, that involved the assessment of people with undiagnosed diabetes; 3) the RECEPTOmetr Sequence study on prescriptions; and 4) regional child diabetes registries. RESULTS: In 2013, 1.76 million people (0.98 million women and 0.79 million men) had medical consultations (coded E10-E14) and 2.13 million people (1.19 million women and 0.94 million men) purchased drugs or strip tests for diabetes. A total of 0.04 million people who used medical services did not buy drugs. In total, the number of people with diabetes in the insurance system was 2.16 million (1.21 million women and 0.95 million men), which corresponds to 6.1% (95% CI 6.11-6.14) of women and 5.1% (95% CI 5.12-5.14) of men. Including undiagnosed cases, the total number of people with diabetes in Poland was 2.68 million in 2013. CONCLUSION: The estimated prevalence of diabetes (diagnosed and undiagnosed cases) in Poland is 6.97%. Data from the national insurance system with full coverage of the population can be treated as a reliable source of information on diseases with well-defined diagnosis and treatment methods, combined with an assessment of the number of undiagnosed individuals.

Thyroid function and morphology in kidney transplant recipients, hemodialyzed, and peritoneally dialyzed patients.

Disturbances in thyroid function are common among patients on renal replacement therapy. The aim of the present study was to compare thyroid stimulating hormone (TSH) and thyroid morphology among patients on hemodialysis (HD), peritoneal dialysis (CAPD), and after kidney transplantation. The study was performed on three groups of patients: 48 transplant recipients (Tx) (receiving cyclosporine, azathioprine, and prednisone); 32 HD, and 26 CAPD patients. The control group included 40 healthy volunteers. Thyroid examinations were performed with a 7.5-MHz probe and the thyroid volume was calculated. Among Tx patients the thyroid volume was 25.16 +/- 12.27mL; 21.60 +/- 10.33mL in HD; 19.70 +/- 8.46 mL in CAPD; and 16.34 +/- 5.46mL in the healthy volunteers. Serum TSH was within the normal range in each group. Goiter was diagnosed in the majority of Tx, most HD patients, and some CAPD patients. Single and multiple nodules were found in 21 Tx, 12 HD, and 2 CAPD patients. Moreover, parathyroid glands were visualized on sonography in 10 Tx, 12 HD, and 8 CAPD subjects. In Tx observed correlations were positive between thyroid volume and creatinine, negative between thyroid volume and TSH. The time after transplantation correlated negatively with TSH. No correlation between TSH, thyroid volume, and time on dialysis was observed. The prevalence in patients on renal replacement therapy was higher than that in the general population. These findings suggest that screening for abnormal thyroid morphology should be performed in kidney patients and that iodide supplementation should be considered in Tx patients.

Is there any relation between thyroid gland function and kidney transplant function?

INTRODUCTION: Patients with chronic renal failure exhibit abnormalities of thyroid function. Reports regarding thyroid function in kidney transplant recipients (TX) are rare, particularly those individuals on long-term immunosuppression. The aim of this study was to investigate correlations between FT3, FT4, TSH concentrations, thyroid volume, and graft function. MATERIAL AND METHODS: The study enrolled 46 kidney allograft recipients (aged 27-67 years,) engrafted between years 1994 and 2000 and clinically stable. The mean time after TX was 45.3 +/- 37.4 months. Transplanted patients received prednisone, cyclosporine, and azathioprine. The control group included 22 patients with normal renal function. In addition to serum creatinine, TSH, FT3, and FT4 concentrations, thyroid examinations were performed with a 7.5-MHz linear probe to calculated the thyroid volume. RESULTS: Thyroid volume in TX patients was 25.3 +/- 13.3 mL. A positive correlation existed between thyroid volume and serum creatinine (P <.05), and a negative one between thyroid volume and TSH (P <.05). No correlation was observed between TSH, FT4, and serum creatinine. The time after TX was negatively related to TSH (P <.05). A negative correlation existed also between FT3 and creatinine in TX patients (P <.05). In the control group the concentrations of TSH and FT3 were within normal ranges. CONCLUSION: The FT3 concentration correlates with function of the renal graft. In TX patients the supplementary thyroid hormone therapy should be considered.

Construction, expression and preliminary characterization of glycosylation mutants of human protein S.

Human protein S (HPS) is a vitamin K dependent plasma glycoprotein involved in the regulation of activated protein C and possibly fibrinolysis. Its c-DNA sequence shows three N-glycosylation consensus sequences (Asn-X-Ser/Thr). In order to study influence of N-linked glycosylation on HPS function, set of mutants of HPS was constructed. Mutants were generated, starting from an SV40/Adeno derived pD5HPS2 expression vector, using PCR enabled, site specific methodology. They included single amino acid substitutions at each of three N-glycosylation consensus sequences: Asn458-->Gln, Ser460-->Gly, Asn468-->Gln, Thr470-->Gly, Asn489-->Gln, Thr491-->Gly. Variant HPS were expressed in stable 293 human kidney cell lines in the presence of vitamin K1 (we did not succeed in expressing variant Asn489-->Gln) and purified from conditioned media using pseudoaffinity chromatography on QAE-Sepharose. Variant Asn468-->Gln showed decreased gamma-carboxyglutamate content. All of the mutants were active in a clotting type assay based on factor Va inactivation, and they were compared to wt-HPS and plasma HPS. In conclusion, we have constructed, expressed and purified set of HPS mutants useful in studying the role of N-glycosylation in HPS function.

[Effect of treating glomerulonephritis with omega 3 fatty acids for selected parameters of hemostasis, blood platelet function and lipid metabolism]. / Wplyw leczenia klebuszkowych zapalen nerek kwasami tluszczowymi omega 3 na wybrane parametry ukladu hemostazy, funkcje plytek krwi oraz gospodarke lipidowa.

Disturbances in serum lipids, hemostasis and platelet functions are frequent features in some kidney diseases and may contribute to the progression of atherosclerosis with its complications. Recently, an attention has been paid on beneficial effects of fish oil on serum lipids and hemostasis, and proteinuria. The purpose of this work was to assess platelet functions, some hemostatic parameters and serum lipids in patients with chronic glomerulonephritis treated with Trienyl. The study was performed on 7 patients with glomerulonephritis, before, 3 and 6 months following fish oil treatment. A small and nonsignificant rise in cholesterol, HDL and LDL was found, whereas triglycerides level fell significantly following 3 and 6 months of therapy Fibrinogen concentration was lowered significantly 6 months following fish oil administration. Platelet aggregation in platelet-rich plasma remained unaltered during therapy, whereas platelet responses to ADP and arachidonic acid in the whole blood were inhibited after 6 months of the therapy. Unsaturated omega 3 fatty acids in Trienyl alter lipid metabolism, platelet/vessel wall interactions and proteinuria and therefore might be beneficial in therapy of glomerulonephritis, particularly in combination treatment.