Comparison of the pleiotropic effect of atorvastatin and rosuvastatin on postmenopausal changes in bone turnover: A randomized comparative study.

BACKGROUND: Statins are the first-line treatment for dyslipidemia, which is a major modifiable risk factor for atherosclerotic cardiovascular disease. Studies have shown that in addition to the beneficial lipid-lowering effect, statins also exhibit a number of pleiotropic effects that may find application in other diseases, including osteoporosis. This study aimed to assess the effect of statins on bone turnover, as measured by the concentration of bone turnover markers, and to compare the effect of atorvastatin as a lipophilic statin and rosuvastatin as a hydrophilic statin. METHODS: This study included 34 postmenopausal women aged < 65 years with newly diagnosed dyslipidemia requiring statin therapy. Patients were randomly assigned to receive a statin drug. Statins were initiated at standard doses of 5 to 10 mg of rosuvastatin and 20 mg of atorvastatin. The levels of C-terminal telopeptide of type I collagen as a bone resorption marker and N-terminal propeptide of procollagen type I as a marker of bone formation, lipid concentrations and other biochemical parameters were assessed at baseline and after 6 and twelve months of treatment. RESULTS: There were no statistically significant differences between the levels of bone turnover markers before and 6 months after statin implementation (P > .05) - for all patients or subgroups according to statin use. Analysis of the results showed that after 12 months, there was a statistically significant decrease in N-terminal propeptide of procollagen type I concentration in all subjects (P = .004). By statin subgroup, a statistically significant decrease in N-terminal propeptide of procollagen type I was observed only in patients receiving rosuvastatin (P = .012) and not in those receiving atorvastatin (P = .25). Moreover, changes in bone turnover markers did not correlate with changes in lipid concentrations. CONCLUSIONS: These results may indicate the superiority of atorvastatin over rosuvastatin in inhibiting adverse changes in bone turnover in postmenopausal women. Confirmed by studies involving a larger population, the observed differences might find particular applications in clinical practice, and the choice of atorvastatin over rosuvastatin for women could be considered in the early postmenopausal period to reduce the risk of osteoporosis and subsequent osteoporotic fractures.

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.

Effects of PCSK9 inhibitors on metabolic-associated fatty liver disease: a short review.

Metabolic-associated fatty liver disease (MAFLD), previously known as non-alcoholic fatty liver disease, is a significant epidemiological problem and a well-known cardiovascular risk factor. The increasing number of cases creates the need for new therapeutic methods aimed at improving patient outcomes. Recent studies have highlighted the relationship between MAFLD and proprotein convertase subtilisin/kexin type 9 (PCSK9). Based on the available data, PCSK9 inhibitors appear to have beneficial effects in patients with MAFLD, and they may be a treatment option in the future. Further research is necessary to better evaluate the efficiency of PCSK9 inhibitors in MAFLD treatment.

Pharmacovigilance practice among pediatric neurologists from Poland and Germany.

OBJECTIVES: To compare the pediatric neurologists' knowledge, practice, and barriers to the pharmacovigilance (PV) process in Poland and Germany. METHODS: The research tool was an online anonymous questionnaire on Google Forms e-mailed to pediatric neurologists from Poland and Germany. RESULTS: The questionnaires were handed out to 830 pediatric neurologists and 371 expressed their consent to participate in the study. Most of the neurologists were familiar with the definition of PV and adverse drug reactions (ADRs). Only 34.10% of pediatric neurologists from Poland, and 38.88% from Germany believe that many ADRs are preventable and almost most of them believe it is necessary to report ADRs from children with epilepsy. Unfortunately, in opposite to this knowledge, only 37.79% of respondents from Poland and 40.32% from Germany felt co-responsible for reporting ADRs. The main reason for the neurologists not to report ADRs was a conviction that reporting ADRs would be an additional burden generating extra work. CONCLUSION: There is no big difference between the practice of PV by pediatric neurologists in Poland and Germany. System-regulated PV stabilization in the country translates into the practice of maintaining PV. Monitoring the safety of pharmacotherapy and knowledge of risks associated with ADRs should be included in the curricula of academic neurologics courses.

Epilepsy is a chronic disorder characterized by episodic, gratuitous seizures. Most children with epilepsy (CWE) rely on antiepileptic drugs causing adverse drug reactions (ADRs). Many ADRs are preventable if physicians actively participate in pharmacovigilance (PV), which its pivotal role is to ensure the safety of pharmacotherapy by e.g. permanent control of ADRs. The study aimed to compare the pediatric neurologists' (PN) knowledge, practice, and barriers to the PV process in Poland and Germany. The research tool was an online anonymous questionnaire on Google Forms e-mailed to PN from Poland and Germany. Only 34.10% of PN from Poland and 38.88% from Germany believe that many ADRs are preventable and almost most of them believe it is necessary to report ADRs from CWE. Unfortunately, in opposite to this knowledge, only 37.79% of respondents from Poland and 40.32% from Germany felt co-responsible for reporting ADRs. The main reason for the neurologists not to report ADRs was a conviction that reporting ADRs would be an additional burden generating extra work. There is no big difference between the practice of PV by PN in Poland and Germany. System-regulated PV stabilization in the country translates into the practice of maintaining PV.

Serum Asprosin Correlates with Indirect Insulin Resistance Indices.

BACKGROUND AND OBJECTIVES: Insulin resistance is a major contributor to the development of type 2 diabetes and can be assessed using indirect indicators calculated from non-invasive tests. Asprosin is a recently discovered adipokine with a postulated effect on glycemic regulation. This study aimed to investigate the correlation between serum asprosin levels and insulin resistance indices. The correlation between circulating asprosin and obesity indices was also investigated. MATERIALS AND METHODS: A total of 50 non-diabetic patients with obesity and 50 healthy volunteers were studied. Laboratory data, including circulating asprosin and anthropometric data, were collected. The following insulin resistance indices were calculated: triglyceride-glucose index (TyG), TyG-neck circumference (TyG-NC), TyG-neck circumference to height ratio (TyG-NHtR), TyG-waist circumference (TyG-WC), TyG-waist to height ratio (TyG-WHtR), TyG-body mass index (TyG-BMI), and the ratio between triglycerides and high-density cholesterol (TG/HDLc). The obtained data were analyzed separately for males and females. RESULTS: Asprosin concentrations were significantly higher in obese patients (p < 0.001). Asprosin concentrations positively correlated with body mass index (p < 0.001, r = 0.8 in females and r = 0.8 in males), waist circumference (p < 0.001, r = 0.73 in females and r = 0.81 in males), and all tested indices of insulin resistance. The strongest correlation was observed for TyG-BMI (p < 0.001, r = 0.78 in females and r = 0.81 in males). Circulating asprosin was higher in females (p < 0.001). CONCLUSIONS: Asprosin can be considered a marker of obesity and insulin resistance.

Association between Compliance with COVID-19 Restrictions and the Risk of SARS-CoV-2 Infection in Poland.

During the coronavirus disease 19 (COVID-19) pandemic it has become very important to comply with preventive measures. We aimed to assess compliance with applicable restrictions and to explore the links between the level of compliance and the risk of COVID-19. This cross-sectional study included Polish adults who were asked to complete a validated questionnaire. The study period was from 1 November 2020 to 31 January 2021 and a computer-assisted web interview method was chosen to perform the survey. The study involved 562 women and 539 men. COVID-19 was reported in 11.26% of participants. A good level of compliance with the sanitary restrictions was reported for 38.87% of participants, an average level of compliance for 47.96%, and a low level of compliance for 13.17%. A reduced risk of COVID-19 was associated with the following preventive measures: regular use of protective masks, social and physical distancing in public places, regular use of hand sanitizers with high ethanol content, and the use of disposable gloves in public places. Our survey revealed satisfactory public compliance with the pandemic restrictions. Sanitary and epidemiologic measures to prevent the pandemic were shown to be adequate and effective.

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.

Impact of the COVID-19 pandemic and lockdown on mental health among the general population in Poland and on the availability of psychological support.

The objective of this paper was to assess the impact of the COVID-19 pandemic on the mental health of Poles and the availability of psychiatric and psychological support during the pandemic. A prospective, cross-sectional web-based survey design was adopted. It was carried out on a sample of 1080 Polish citizens above 18 years old. The majority of Poles (70%) experienced symptoms of mental disorders during the COVID-19 pandemic. Sleep disturbance (63.79%), anxiety (48.79%), low mood for most of the day (44.63%), sadness, tearfulness (41.29%), and concentration disorders (35.93%) were the mental disorder symptoms reported most often by the survey subjects. To reduce the potential acute and long-lasting effects of the COVID-19 pandemic on mental health, decision-makers of the Polish health system should implement stepped multilevel and multi-target psychological support services.

Impact of the SARS-CoV-2 Vaccination Program on Presenteeism and Absenteeism among Healthcare Workers in Poland.

BACKGROUND: There is sufficient scientific literature on the effectiveness of registered vaccines in preventing SARS-CoV-2 infection, but research on the impact of the COVID-19 vaccination program on social and economic aspects is lacking. In connection with the above, this study aimed to assess the impact of vaccinations on presenteeism and absenteeism among healthcare professionals in the workplace caused by the COVID-19 pandemic. METHODS: A post-marketing, cross-sectional survey-based study was carried out on a sample of 736 actively employed healthcare professionals. Among them, 215 individuals (29.21%) were unvaccinated (control group). The study group consisted of 521 vaccinated respondents, with 52.97% being women and 47.03% men. A self-administered questionnaire was developed and delivered online to the target population group of healthcare workers. RESULTS: A significant association (p < 0.01) was observed between the number of doses of the COVID-19 vaccine received and presenteeism among the respondents. Among the unvaccinated respondents (2.30 ± 1.19) or those vaccinated with only one dose of the SARS-CoV-2 vaccine (2.16 ± 1.11), the COVID-19 pandemic had a significantly higher impact on work performance compared to individuals vaccinated with three doses of the vaccine (1.19 ± 1.11). Moreover, a significant association was found (p = 0.0265) between the number of workdays missed (over the last twelve months) due to COVID-19-related sick leave and the number of doses of the COVID-19 vaccine received. The number of workdays missed due to COVID-19 sick leave was lowest in the group vaccinated with three doses (2.00 ± 6.75) and highest in the unvaccinated group (5.32 ± 16.24). CONCLUSIONS: Our results clearly show that the widely implemented national COVID-19 vaccination program brings tangible benefits both in medical and economic terms. The extent of reducing absenteeism and presenteeism caused by the coronavirus disease depended on the number of vaccine doses administered.

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.

Safety Profile of COVID-19 Vaccines among Healthcare Workers in Poland.

The aim of the study was to compare the safety profiles (prevalence of both local and systemic side effects) of COVID-19 vaccines (Pfizer−BioNTech, Moderna, Oxford−AstraZeneca) among healthcare workers (doctors, nurses, and pharmacists) administered with a first and a second dose of the vaccines. Another goal of the research was to evaluate potential demographic and clinical risk factors for the frequency and intensity of side effects. A post-marketing, cross-sectional survey-based study was carried out on a sample of 971 respondents (323 doctors, 324 nurses, and 324 pharmacists), all more than 18 years old, who have taken two doses of the following SARS-CoV-2 vaccines: BNT162b2 (Pfizer−BioNTech) (group 1), mRNA-1273 (Moderna) (group 2), and ChAdOx1 nCoV-19 (Oxford−AstraZeneca) (group 3). A validated, self-administered questionnaire was developed and delivered online to the target population group of healthcare workers. The survey was conducted during the third wave of the COVID-19 (1 February 2021−1 July 2021) pandemic. It was based on the CAWI (computer-assisted web interview) method. Questionnaires were disseminated using selected social media. The BNT162b2 (Pfizer−BioNTech) vaccine was the most commonly administered COVID-19 vaccine among healthcare professionals in Poland (69.61%). Side effects following a SARS-CoV-2 vaccine were reported by 53.11% of respondents in group 1, 72% in group 2, and 67.59% in group 3. The following were the most common side effects regardless of the type of vaccine administered: pain at the injection site, headache, muscle pain, fever, chills, and fatigue. The number and intensity of reported side effects following administration of a BNT162b2 (Pfizer−BioNTech) vaccine were significantly lower than in the other two study groups (p < 0.00001). Risk factors for side effects following administration of one of the SARS-CoV-2 vaccines subject to the analysis included being female, young, and suffering from a diagnosed allergy. Our results clearly show that the short-term safety profiles of the eligible COVID-19 vaccines (Pfizer−BioNTech, Moderna, Oxford−AstraZeneca) are acceptable. Nevertheless, the two-dose COVID-19 vaccines available in Poland differ significantly in the frequency of both local and systemic side effects and their intensity. Women, young people, and patients diagnosed with allergies are particularly exposed to the risk of side effects. Further studies are needed to determine the long-term safety profile of COVID-19 vaccines.

The Impact of Health Policy on Patients' Awareness of the Risks Associated with Obesity: An International Multicenter Study in Poland and Germany.

Background: Recent studies indicate that the treatment of obesity is unsuccessful. The cause of this situation is that patients are not sufficiently educated about therapeutic methods and the health consequences of not treating obesity. Moreover, obesity prevention strategies differ significantly between EU countries. Objective: The primary aim of this study was to examine and compare the level of obesity-related knowledge and illness perception among obese patients from Poland and Germany. Methods: A prospective cross-sectional international multicentre study was conducted. The study included 564 subjects above 18 years old (210 German patients and 354 Polish patients) with obesity. A validated custom-made questionnaire was used to evaluate obesity-related knowledge. Patient illness perception was evaluated using Polish and German language versions of the standardized Brief Illness Perception Questionnaire (B-IPQ). Results: Obese patients from Germany had significantly higher level of obesity-related knowledge than patients from Poland (22.01 ± 4.68 vs 19.17 ± 6.59, p<0.0001). Obesity-related knowledge was associated with the patient's education, patient participation in therapeutic educational programs, patient's perception of the illness, age and the number of healthcare professionals involved in the patient's treatment process. Conclusion: The level of obesity-related knowledge among both Polish and German patients is unsatisfactory. This study suggests that health education is required to facilitate informed choices and support the use of cognitive approaches educating patients on the health consequences of obesity.

Assessment of the Impact of the COVID-19 Pandemic on the Pro-Health Behavior of Poles.

The SARS-CoV-2 virus pandemic has exerted enormous impacts on individuals' lifestyle, economics and social life. The aim of the study was to assess the impact of the COVID-19 pandemic on health-promoting behaviors of a sample of the Polish population, including dietary supplementation, physical activity, eating habits, and the implementation of preventive vaccinations. Within the scope of a survey, data was collected from 1101 adult respondents residing in Poland (862 women and 239 men). An anonymous questionnaire prepared based on the scientific literature was used as a research tool. The survey was conducted during the second wave of COVID-19 using the CAWI (Computer-Assisted Web Interview) method by disseminating the questionnaire using selected social media. We found that, during the COVID-19 pandemic, the respondents were more likely to maintain healthy eating habits and use dietary supplementation; however, the majority engaged in physical activity less frequently and had a sedentary lifestyle. Most felt no need to undergo preventive influenza vaccinations. The COVID-19 pandemic significantly increased the health awareness of the analyzed group from the Polish population. However, the obtained results are not fully satisfactory; therefore, there is a need to promote a healthy lifestyle and pro-health behaviors as part of social campaigns.

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.

A Comparison Between the Therapeutic Effect of Metformin Alone versus a Combination Therapy with Insulin in Uncontrolled, Non-Adherence Patients with Type 2 Diabetes: Six Months Follow-Up.

PURPOSE: The study aimed to compare the metabolic effects of an intensive dose of metformin alone among non-adherence patients with type 2 diabetes versus in combination with insulin among adherence patients. METHODS: The prospective cohort study was carried out on a sample of 140 patients above 18 years old, divided into two groups. The first group (n=70) was recommended metformin monotherapy in an intensive dose of 2-3 g/day, whereas the second group (n=70) was prescribed metformin (1-2g/day) in combination with insulin. FPG, HbA1c, BMI, blood pressure, TC, TG, HDL-C, LDL-C, creatinine, and eGFR were measured for each patient at baseline and after a follow-up of 6 months of active treatment. RESULTS: After six months of active treatment using monotherapy with an intensive dose of metformin, only 11.43% of patients achieved the target levels of HBA1c below 7%. In the group of patients treated using a combination of metformin with insulin, after six months of active treatment, 45.72% achieved HBA1c levels below 7% (p<0.0001). Compared with an intensive dose of metformin alone, the combination of insulin and metformin was associated with improved glycemic control (change of fasting blood glucose: 2.49 mmol/l vs 1.30 mmol/l, p=0.0016). Metformin use alone, as compared with insulin, was associated with a significant increase in HDL-C (+0.03 mmol/l vs -0.14 mmol/l, p=0.0485). Increased baseline obesity and increased baseline glycemia were the factors related to the likelihood of failing to achieve the target levels for HbA1c. CONCLUSION: Metformin proved to be more effective in controlling hyperglycemia when combined with insulin therapy. Our study shows how many health benefits loss patients who, despite systematic diabetes education, do not agree to change their treatment in the form of adding a second drug, including insulin.

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.

Clinical Characteristics of Hypertensive Patients with Obstructive Sleep Apnoea Syndrome Developing Different Types of Left Ventricular Geometry.

OBJECTIVE: The objective of the study was to compare polygraphic parameters and selected laboratory parameters in patients with obstructive sleep apnoea (OSA) who develop various types of left ventricular (LV) geometry. Material and Methods. The research covered 122 patients with obstructive sleep apnoea and coexisting effectively treated systemic hypertension (95 men, 27 women, average age: 54 ± 10.63). Overnight polygraphy, echocardiography, carotid artery ultrasonography, and laboratory measurements were performed. The patients were classified into four groups, depending on LV geometry. Group 1 comprised patients with normal LV geometry, group 2 included those with LV concentric remodelling. Group 3 and group 4 were patients with LV hypertrophy, concentric or eccentric, respectively. RESULTS: The most frequent type of LV geometry in the examined population was eccentric hypertrophy (36%). The highest average values of BMI and T-Ch were observed in the group of patients with concentric remodelling (group 2). The most severe respiratory disorders were found in the group of patients developing LV concentric hypertrophy (group 3); however, these differences were not statistically significant in comparison to other groups. Patients with LV eccentric hypertrophy had significantly decreased LV ejection fraction (p = 0.0008). CONCLUSIONS: LV eccentric hypertrophy is the most frequent type of LV geometry in OSA patients. Patients with severe sleep-disordered breathing are more likely to develop concentric hypertrophy, while concentric remodelling occurs more frequently among OSA patients with other coexisting conditions, such as obesity or lipid-related disorders.