Evaluation of selected factors influencing sleep disorders in paramedics during the COVID-19 pandemic.

Introduction: Sleep disorders can develop as a result of exposure to stressors. The outbreak of the COVID-19 pandemic was an additional source of stress for paramedics, due to the fear of the unknown nature of the new pathogen. The main aim of this study was to identify factors influencing the development of sleep disorders among paramedics working during the COVID-19 pandemic. Material and methods: This was a cross-sectional, anonymous, voluntary, online survey conducted on social networks among paramedics working during the COVID-19 pandemic in Poland from 10/11/2020 to 14/01/2021. The survey included 387 participants, the majority of whom were men (72.35%). A proprietary questionnaire and standardized scales were used to identify risk factors: Athens Insomnia Scale (AIS) and Epworth Sleepiness Scale. Results: Among all participants, there were 107 (27.65%) women and 280 (72.35%) men. Significantly higher scores of the analyzed scales were observed in the female gender. Based on the AIS scale, mild sleep disorders were found in 3.6% of women and 2.9% of men. Excessive sleepiness on the Epworth scale was assessed in more than 70% of women and 58.8% of men working in Emergency Medical Teams (EMTs). Conclusions: The main factors influencing the development of sleep disorders were female gender, use of sleep aids and not having a life partner. In contrast, older age and longer job tenure, being married, and having good relationships with family members had a protective effect.

Impact of Selected Sociodemographic and Clinical Parameters on Anxiety and Depression Symptoms in Paramedics in the Era of the COVID-19 Pandemic.

INTRODUCTION: The emergence of the SARS-CoV-2 virus, which caused the outbreak of the pandemic declared by the World Health Organization (WHO, World Health Organization) on 11 March 2020, has resulted in the introduction of many restrictions worldwide to contain the rapidly spreading pathogen. A particularly vulnerable professional group are paramedics working in Emergency Medical Teams. AIM: The main aim of this study was to investigate the influence of selected sociodemographic and clinical parameters on anxiety and depression symptoms in paramedics during the COVID-19 pandemic. MATERIALS AND METHODS: The study involved 387 paramedics working in Medical Rescue Teams in Poland. The majority of respondents were male (72.35%). In order to achieve the aim of the study, an online diagnostic survey was conducted using a questionnaire of the author's own design and standardized questionnaires: Hospital Anxiety and Depression Scale (HADS) and General Anxiety Disorders (GAD-7). RESULTS: Significantly higher values were observed for all analysed scales in females compared to males. The main factors influencing the occurrence of anxiety and depression symptoms were gender, seniority at work, family relations, use of sleeping pills. Alcohol consumption increased in this professional group during the pandemic. CONCLUSIONS: Females and users of sleep medication who work in the emergency department during a pandemic are more likely to experience symptoms of depression and anxiety. A longer length of service and satisfying relationships with family are factors in reducing these symptoms. Paramedics who are in informal relationships and single manifest more emotional problems compared to those who are married. Increased alcohol consumption can be considered as a way of coping with stress. However, further studies in this professional group are needed to assess the further impact of the pandemic on psychiatric symptoms among emergency medical workers.

EMOTIONAL PROBLEMS AND SLEEP DISTURBANCES IN PARAMEDICS IN THE ERA OF THE COVID-19 PANDEMIC.

Infectious diseases have accompanied mankind for centuries, and the effects of their dramatic course are felt on many levels of everyday life. The COVID-19 pandemic caused by SARS-CoV-2 virus infection carries a tremendous psychological burden for both those infected and health care workers. Particularly vulnerable to psychological strain are paramedics who have direct contact with and caring for patients infected with coronavirus. From a review of the literature, it is known that Emergency Medical Team members, as a result of the stress experienced during a pandemic, manifest symptoms such as depression, anxiety, and sleep disturbances. In order to limit the adverse impact of the pandemic on the mental condition of this professional group, it is necessary to create appropriate conditions for solitary rest, relaxation and satisfaction of basic needs such as: food, sleep and protective clothing. An important role is also played by unrestricted access to psychological support in the broad sense of the word and often also to psychiatric care.

Evaluation of the results of treatment of morbid obesity by the endoscopic intragastric balloon implantation method.

INTRODUCTION: Overweight and obesity are ranked in the fifth place among the risk factors responsible for the greatest number of deaths in the world. AIM: To assess the effects of treatment of patients with morbid obesity using endoscopic intragastric balloon (IGB) implantation. MATERIAL AND METHODS: Two hundred and seventy-two patients with obesity were treated using endoscopic intragastric balloon implantation. Upon analysis of the inclusion and exclusion criteria, the study covered a group of 63 patients with morbid obesity. The patients were implanted with the LexBal balloon. Reduction of excess body mass, changes to BMI values and ailments and complications divided into mild and severe were assessed. RESULTS: Before intragastric balloon treatment, the average body mass index (BMI) value was 58.3 ±10.5 kg/m2, whereas after 6 months of treatment it decreased to 49.5 ±8.7 kg/m2. The patients with postoperative BMI equal to or greater than 50.0 kg/m2 reported nausea (69.7%), vomiting (51.5%), flatulence (45.5%), upper abdominal pain (36.4%) and general discomfort (424%) more frequently. Dehydration (9.1%) was also more frequent in this group, whereas frequency of occurrence of such ailments and complications as heartburn (23.3%) and oesophageal candidiasis (10.0%) was higher in the patients with postoperative BMI below 50.0 kg/m2. CONCLUSIONS: Endoscopic intragastric balloon implantation is an effective and safe method of excess body mass reduction in patients with morbid obesity before a planned bariatric surgical procedure. Pre-operative excess body mass and BMI value and post-operative excess weight loss in patients with morbid obesity have no impact on frequency of occurrence of ailments and complications in IGB treatment.

The effects of obesity on CD47 expression in erythrocytes.

BACKGROUND: To investigate the effects of obesity on CD47, phosphatidylserine (PS) exposure, and Caspase-8 and Caspase-3 activities in erythrocytes. METHODS: The study included 25 morbidly obese patients and 20 healthy people as the control group. We evaluated CD47 expression on the red blood cell (RBC) membrane surface and eryptosis markers such as PS externalization and caspase activity using flow cytometric analyses. RESULTS: CD47 expression on the RBC surface was significantly lower in obese patients than in the control group (P = 0.000001). We did not find significant differences in the Caspase-3 and Caspase-8 activities between the obese and nonobese control groups. Additionally, we did not find differences in PS exposure on erythrocyte membranes. The fibrinogen levels were higher in the obese group than they were in the control group (P = 0.00002). Correlations between CD47 expression and body mass index (r = -0.65; P = 0.0004), waist circumference (r = -0.54; P = 0.0052), and fibrinogen (r = 0.57; P = 0.0024) were found. Univariate analyses revealed that body mass index, waist circumference, hip circumference, and fibrinogen levels were potential predictors of CD47 expression. Multivariate analyses found that fibrinogen levels (ß = 0.4708; P = 0.045) independently predicted CD47 expression. CONCLUSIONS: The study demonstrated that CD47 expression is decreased on the surface of RBCs in obese subjects. These changes in CD47 expression on the RBC surface may be an adaptive response to hyperfibrinogenemia associated with obesity. © 2015 International Clinical Cytometry Society.

Influence of Obesity on Anastomotic Leakage After Anterior Rectal Resectionperformed Due to Cancer.

UNLABELLED: Anterior resection for rectal cancer carries the risk of serious complications, especially fistulas at the site of anastomosis. Numerous factors have been shown to impact anastomotic leakage. The results of studies on the influence of obesity on the frequency of anastomotic leakage after rectal resection performed due to cancer have been contradictory. The aim of the study was to evaluate the relationship between body mass index (BMI) and frequency of anastomotic leakage after anterior rectal resection performed due to cancer. MATERIAL AND METHODS: This retrospective analysis included 222 subsequent patients who had undergone anterior resection due to cancer with an anastomosis formed with a mechanical suture. The patients were divided into 3 groups depending on their BMI quartile as follows: Group I, BMI < 23.8 kg/m2 (lower quartile); group II, BMI between 23.8 and 29.38 kg/m2 (middle quartile); and group III, BMI > 29.38 kg/m2 (upper quartile). RESULTS: Anastomotic leakage occurred in 8 (3.6%) patients. Fistulas occurred in 4 out of 61 patients (6.56%) in group I, which was the highest incidence of fistulas for all 3 groups. In group II, fistulas occurred in 2 out of 55 patients (3.63%), and similarly, in group III, they occurred in 2 out of 106 patients (1.87%). The differences found in the frequency of fistulas between groups were not statistically significant (p=0.31). The logistic regression analysis did not show any relationship between leakage and age (p = 0.55; OR = 1.02; 95% CI: 0.95 - 1.1), sex (p = 0.97; OR = 0.97; 95% CI: 0.22 - 4.25) or BMI (p = 0.27; OR = 0.58; 95% CI: 0.22 - 1.53). CONCLUSIONS: The results of our study show that BMI did not have any influence on the frequency of anastomotic leakage after anterior rectal resection performed due to cancer.

The effects of weight loss surgery on blood rheology in severely obese patients.

BACKGROUND: The effects of dieting on blood rheology in obese individuals suggest that improving the rheologic profiles depends on the amount of weight lost and its long-term maintenance. The aim of this study was to evaluate the effects of weight loss after surgery on blood rheology at 12-month follow-up. METHODS: We studied 38 obese patients who underwent laparoscopic weight loss surgery, 22 of whom had sleeve gastrectomy (SG) and 16 of whom had gastric banding (LAGB). We evaluated rheologic parameters such as blood viscosity, plasma viscosity, and erythrocyte deformability (as measured by elongation index [EI]) preoperatively and 12 months after surgery. RESULTS: Whole blood viscosity at 150 s(-1) shear rate (P<.01) and 300 s(-1) shear rate (P<.05), blood viscosity corrected to a standard hematocrit at both shear rates (P<.0005 and P<.005, respectively), and plasma viscosity (P<.005) were significantly reduced after surgery. EI evaluated at different shear stresses (18.49-60.03 Pa) decreased (P<.005) 12 months after surgery. There were significantly decreased EI and blood viscosity corrected to a standard hematocrit after SG (P<.005 and P<.05) and LAGB (P = .0621 and P<.05), but plasma viscosity significantly decreased only after SG (P<.005). Blood viscosity at both shear rates correlated with plasma viscosity (r = .51, P<.005 and r = .5, P<.005). Plasma viscosity correlated positively with body mass index (r = .57; P<.0005) and negatively with percentage of excess weight lost (r = -.56; P< .005). CONCLUSIONS: This study found that weight loss after bariatric surgery induced improvement in blood rheology in obese patients at 12 months after surgery. The increased red blood cell rigidity after surgery requires further study because the physiologic importance of this change has not yet been established.

Measles outbreak registered by the District Sanitary-Epidemiological Station in Czestochowa in 2013.

INTRODUCTION: Since 2001, Poland has been committed to measles elimination programme coordinated by the World Health Organization. This programme is intended to sustain 95% coverage with measles vaccines and ensure laboratory confirmation of suspected measles cases. In 2013, a total of 89 measles cases were reported in Poland. Of them, 14 cases were notified to the District Sanitary-Epidemiological Station (DSES) in Czestochowa. PURPOSE. The purpose of this study was to evaluate the epidemiological situation of measles in Czestochowa with focus on the increase in measles incidence observed in the second quarter of 2013. MATERIAL AND METHODS: To analyze the epidemiological situation of measles, the reports on the cases of infectious diseases and poisonings in Poland in 2000-2013 (MZ-56) from the National Institute of Public Health-National Institute of Hygiene (NIPH-NIH) and Czestochowa DSES were employed. The analysis of immunization coverage of children and adolescents in selected year groups in 2009-2012 was performed using the data retrieved from annual reports issued by Czestochowa DSES (MZ-54). RESULTS: In 2000-2012, three cases of measles were notified to Czestochowa DSES. Of them, two cases and one case were reported in 2003 and 2011, respectively. In 2013, an increase in the number of measles cases and measles incidence was observed. A total of 14 adult cases, aged 22-38 years, were reported and the incidence was 3.78 per 100,000. Of them, 13 cases were males (93% of the total). The infection affected 8 inmates of the Day Care Centre in Czestochowa, 2 individuals who lived near this institution and 4 individuals who were not epidemiologically linked to the outbreak. Of the cases, 12 individuals were hospitalized, i.e. 86% of all cases. Of 14 reported cases, only one individual had a history of measles vaccination. CONCLUSIONS: Measles remains a highly infectious disease which can be easily transmitted in the unvaccinated population.

Literature review of non-operative management of patients with blunt splenic injury: impact of splenic artery embolization.

Splenic injuries constitute the most common injuries accompanying blunt abdominal traumas. Non-operative treatment is currently the standard for treating hemodynamically stable patients with blunt splenic injuries. The introduction of splenic angiography has increased the possibility of non-operative treatment for patients who, in the past, would have qualified for surgery. This cohort includes mainly patients with severe splenic injuries and with active bleeding. The results have indicated that applying splenic angioembolization reduces the frequency of non-operative treatment failure, especially in severe splenic injuries; however, it is still necessary to perform prospective, randomized clinical investigations.

Impact of weight loss due to sleeve gastrectomy on shear stress of the femoral vein in morbid obesity.

BACKGROUND: Studies have shown that obesity is associated with venous flow disturbances that lead to changes of the biomechanical forces on the venous wall known as shear stress. We hypothesized that weight loss due to bariatric surgery affects the venous hemodynamics and biomechanical forces on the venous wall. The aim of this study was to evaluate the effects of laparoscopic sleeve gastrectomy (LSG) on the wall shear stress (WSS) and the venous hemodynamics of the femoral vein. METHODS: We studied ten morbidly obese patients who underwent LSG. We investigated venous hemodynamics before, 6 and 12 months after LSG. The femoral vein diameter, cross-sectional area, peak (PeakV) and maximum (TAmax) velocities, WSS, and shear rate (SR) were assessed. RESULTS: PeakV and TAmax were significantly lower in the obese patients compared with the control group. WSS and SR were significantly lower in the obese patients compared with the control subjects. Venous hemodynamic parameters increased in the postoperative period at baseline compared with 12 months after surgery: PeakV increased from 17.53 (14.25-20.01) cm/s to 25.1 (20.9-30.1) cm/s (P = 0.04) and the TAmax from 12.97 (11.51-14.6) cm/s to 18.46 (13.24-24.13) cm/s (P = 0.057). WSS significantly increased from 0.21 (0.19-0.23) Pa at baseline to 0.31 (0.23-0.52) Pa 12 months after surgery (P = 0.031). SR also significantly increased from 47.92 (43.93-58.55) s(-1) at baseline to 76.81 (54.04-109.5) s(-1) 12 months after surgery (P = 0.02). CONCLUSIONS: This study showed that weight loss due to LSG significantly changes the biomechanical forces on the femoral vein generated by blood flow.

The impacts of super obesity versus morbid obesity on red blood cell aggregation and deformability among patients qualified for bariatric surgery.

The aim of this study was to evaluate the effects of the obesity degree on red blood cell aggregation and deformability. We studied 56 obese patients before weight loss surgery who were divided into two groups: morbid obesity and super obesity. The aggregation and deformability of RBCs were evaluated using a Laser-assisted Optical Rotational Cell Analyzer (Mechatronics, the Netherlands). The following parameters specific to the aggregation process were estimated: aggregation index (AI), aggregation half-time (t1/2) and threshold shear rate (γthr). RBC deformability was expressed as erythrocyte elongation (EI), which was measured at 18.49 Pa and 30.2 Pa shear stresses. Super obese patients presented significantly higher AI (P < 0.05) and γthr (P < 0.05) and significantly lower t1/2 (P < 0.05) compared with morbidly obese individuals. Multivariate analyses showed that fibrinogen (ß 0.46, P < 0.01 and ß 0.98, P < 0.01) and hematocrit (ß 0.38, P < 0.05 and ß 1.01, P < 0.01) independently predicted the AI in morbidly obese and super obese patients. Fibrinogen (ß -0.4, P < 0.05 and ß -0.91, P < 0.05) and hematocrit (ß -0.38, P < 0.05 and ß -1.11, P < 0.01) were also independent predictors of the t1/2 in both obese groups. The triglyceride level (ß 0.32, P < 0.05) was an independent predictor of the t1/2 in the morbidly obese group. No differences in EI were observed between obese subjects. Multivariate analyses showed that the triglyceride level independently predicted EI at 18.49 Pa (ß -0.42, P < 0.05 and ß -0.53, P < 0.05) and 30.2 Pa (ß -0.44, P < 0.01 and ß -0.49, P < 0.05) in both obese groups. This study indicated that the obesity degree of patients who qualify for bariatric surgery affects RBC aggregation properties, but it does not indicate the reasons for this difference. Further studies are needed to determine factors associated with hyperaggregation in super obesity.

Association between hemorheological alteration and clinical diagnosis of metabolic syndrome among patients qualified for bariatric surgery.

This study presents the association between metabolic syndrome and hemorheological parameters among obese patients qualified for bariatric surgery. We studied 73 morbidly obese patients who were qualified for bariatric surgery. Blood and plasma viscosity measurements were performed using a cone-plate viscometer (Brookfield DV-II). RBC aggregation was measured using the Laser-assisted Optical Rotational Cell Analyser (LORCA). The following parameters for the aggregation process were estimated: aggregation index (AI), amplitude (AMP), aggregation half-time (t1/2), threshold shear rate (γthr), the fast (Tfast) and the slow (Tslow) component. Metabolic syndrome was defined according to the Adult Treatment Panel III and International Diabetes Federation criteria. The obese presented differences in all rheological properties compared to control, regardless of clinical diagnosis of metabolic syndrome, except that whole blood viscosity was higher only in the obese metabolic syndrome group. No differences among the obese with and without metabolic syndrome were observed except in hematocrit. Whole blood viscosity and corrected blood viscosity correlated positively with WHR and BMI. AI, γthr, Tslow correlated positively with BMI, WHR, total cholesterol level and low-density lipoproteins. Negative correlation presented t1/2 with BMI, WHR, fibrinogen, total cholesterol level and low-density lipoproteins. The study showed that morbid obesity is associated with hemorheological disturbances independently of clinical diagnosis of metabolic syndrome.

Fast track in large intestine surgery - review of randomized clinical trials.

Fast track surgery is a specific perioperative procedure. Its aim is to reduce the number of complications, to improve the comfort and satisfaction of treated patients and to shorten the time of their hospital stay. In this paper we present randomized clinical trials relating to fast track surgery including patients after colorectal resection.

Shear stress and flow dynamics of the femoral vein among obese patients who qualify for bariatric surgery.

The aim of this study was to evaluate the effects of obesity on wall shear stress and its relationship to erythrocyte aggregation. We studied 35 morbidly obese patients who were qualified for bariatric surgery. The control group consisted of 20 non-obese people. Blood rheological measurements were performed using the Laser-assisted Optical Rotational Cell Analyzer (Mechatronics, the Netherlands) and a cone-plate viscometer (Brookfield DV-II). The venous flow dynamics were assessed using a duplex ultrasound. The shear rate was estimated from the measured blood flow velocity and the diameter of the femoral vein. Venous wall shear stress was calculated from the whole blood viscosity and the shear rate. The shear rate (P < 0.005) and the venous wall shear stress (P < 0.05) were significantly lower in obese patients compared with the controls. The aggregation index (P < 0.001), syllectogram amplitude - AMP (P < 0.05) and Tslow (P < 0.001) were significantly higher in the obese patients; the aggregation half-time (P < 0.001) and Tfast (P < 0.001) were decreased compared with the control group. Multivariate regression analyses found waist circumference (ß -0.31, P < 0.05), thigh circumference (ß 0.33, P < 0.05) and Tslow (ß -0.47, P < 0.005) to be variables that independently influenced the shear rate. Nevertheless, the AMP (ß 0.34, P < 0.05) and Tslow (ß -0.47, P < 0.01) were independent predictors that influenced the wall shear stress. This study indicates that there is a relationship between wall shear stress in the femoral vein and the rheological impairment of the RBC among obese patients, but further studies are necessary to confirm this suggestion.

Mortality and anastomotic leakage after anterior resection for rectal cancer.

BACKGROUND/AIMS: The aim of the study was to analyze the mortality and symptomatic anastomotic leak following stapled anastomosis after anterior resection for rectal cancer. METHODOLOGY: We analyzed retrospectively 161 patients subjected to elective anterior resection of the rectum. There were 102 (63.3%) men and 59 (37.7%) women. The patients were divided into two groups according to tumor location: group I - 129 (80.1%) patients with tumor located >6 cm from the anal verge and group II - 32 (19.9%) patients with tumor located =6 cm. RESULTS: Anastomotic leak was found in 5 (3.1%) patients, three (2.3%) from group I and two (6.2%) from group II (p<0.26). Anastomotic leak was found more often in patients with renal failure (p<0.0023) and in those who had undergone RBC concentrate transfusion (p<0.0045). Seven (4.3%) patients died in the postoperative period. Deaths occurred more frequently in patients with valvular heart disease (p<0.00002), renal failure (p<0.0047) and in those given concentrates of RBC (p<0.045). CONCLUSIONS: Incidence of postoperative surgical complications after resection for rectal cancer is not high and is acceptable; however, there is an increased risk of leakage after low anterior resection. Renal failure as well as RBC concentrate transfusion have an influence on mortality and anastomotic leak.

[Adverse events following immunization reported to the district sanitary-epidemiological station in Czestochowa in 2006-2010]. / Niepozadane odczyny poszczepienne zgloszone do powiatowej stacji sanitarno-epidemiologicznej w Czestochowie w latach 2006-2010.

INTRODUCTION: Obligatory reporting of adverse effects following immunization (AEFI) was introduced in Poland in 1995. In 2006-2010 number of AEFI reported to the District Sanitary-Epidemiological Station in Czestochowa was 70. For the same period in the whole country 4552 cases were reported. PURPOSE: Purpose of the study was to perform epidemiological analysis of cases reported in Czestochowa and to compare the results with the data for the whole country. MATERIALS AND METHODS: For analysis AEFI, data was obtained from the AEFI register held in PSSE in Czestochowa, and the data of National Institute of Public Health-PZH for 2006-2010. The analysis included the number and frequency of AEFI, the type of vaccine involved with the cases, and the character of the reaction. RESULTS: Most frequently, AEFI reported to the PSSE occured after BCG vaccination--15 cases (21.4% of the total) and after DTP--14 cases (20%). AEFI other than BCG occurred in 55 cases, representing 78.6% of all reported. 37 AEFI (53% of all reported cases) was after vaccines with the pertussis component . In all instances, AEFI against measles, mumps and rubella occurred after the first dose of vaccine. In the analyzed period, it was observed steady increase in the total number of AEFI, which was associated with the increase in the number of infections covered by the vaccinations: Haemophilus influenzae type b, pneumococcal, varicella, human papillomavirus, and rotavirus. Adverse events following immunization reported in 2006-2010 to the PSSE in Czestochowa were mild reactions, which did not result in permanent adverse health complications. Trends for changes in the epidemiology ofAEFI in Czestochowa are similar to those in the the entire country. CONCLUSION: The observed increase in the total number of AEFI is associated with an increase in the number of vaccinations performed in Poland.

The role of laparoscopy in abdominal trauma - review of the literature.

The necessity of urgent explorative laparotomy as a standard procedure in the treatment of abdominal penetrating wounds is controversial. Mandatory surgical intervention for penetrating abdominal trauma yields a high rate of negative laparotomies in the absence of visceral injuries. Laparoscopy is an alternative diagnostic procedure inspecting the peritoneum for signs of perforation and excluding significant intra-abdominal injuries. Following current guidelines, diagnostic laparoscopy should be used with caution only in selected cases due to the limited amount of reliable data confirming the effectiveness of such treatment. We present a review of the literature analysing the role of diagnostic laparoscopy in abdominal trauma.

Sex-dependent differences in rheological properties and the relation of blood viscosity to erythrocyte aggregation indices among morbidly obese patients.

Some studies indicate that obesity is associated with rheological disturbances. Because there are usually sex differences in the type of obesity we decided to evaluate rheological differences between male and female obese patients. We studied 18 morbidly obese men, mean age 43.66 +/- 11.32 years, mean body mass index (BMI) 49.82 +/- 6.03 kg/m2 and 20 obese females, mean age 40.6 +/- 11.86 years, mean BMI 47.41 +/- 8.81 kg/m2. Blood and plasma viscosity measurements were performed using a cone-plate viscometer (Brookfield DV-II). Erythrocyte elongation and red blood cell (RBC) aggregation were measured using the Laser-assisted Optical Rotational Cell Analyser (LORCA). Whole blood viscosity and RBC deformability expressed by the elongation index were significantly higher in obese men. We did not observe differences in plasma viscosity, corrected blood viscosity and aggregation parameters among the obese population. Blood viscosity correlated with selected RBC aggregation indices. We conclude that morbidly obese patients presented sex-dependent differences in some rheological properties. This study indicates a relation between erythrocyte aggregation indices and blood viscosity in obese populations.

The efficacy of alendronate in wheelchair-bound patients: a 1-year prospective study.

The aim of the study was to establish the efficacy of 1-year alendronate treatment in 10 wheelchair-bound participants. In the study were included participants with z-score lower than -2.0 in one of three skeletal sites. Bone status was assessed using dual-energy X-ray absorptiometry at calcaneus and forearm and using quantitative ultrasound at hand phalanges at baseline and after a year. Laboratory variables included serum carboxyterminal telopeptide of type I collagen (ICTP) and bone alkaline phosphatase. Mean values of bone measurements did not differ between baseline and follow-up, the mean value of ICTP nonsignificantly increased and bone alkaline phosphatase significantly dropped (P<0.01). No patient treated revealed the increase in three bone densitometric variables and only one showed a decrease in ICTP exceeding 40% of baseline value. Concluding, in wheelchair-bound participants short-term alendronate therapy does not reduce bone resorption and does not improve the skeletal status.

Neopterin--a potential factor for differentiation between pancreatic cancer and chronic pancreatitis.

BACKGROUND/AIMS: Pancreatic cancer constitutes a difficult diagnostic and therapeutic problem. It remains the fourth cause of death among gastrointestinal malignancies. The present study aimed to investigate whether neopterin can be used as a significant marker in pancreatic cancer and to establish any possible relationships between serum neopterin levels and the differentiation between chronic pancreatitis, pancreatic cancer, and acute pancreatitis. METHODOLOGY: The research was done on a group of 65 patients with a diagnosed pancreatic tumor and on a group of 21 patients with a diagnosed acute pancreatitis. Serum neopterin concentration was determined in all patients on the first day of hospitalization. RESULTS: Based on intraoperative and postoperative histopathological findings, pancreatic cancer was diagnosed in 42 patients and chronic pancreatitis in 23 patients. Neopterin concentrations in pancreatic cancer patients, chronic pancreatitis patients, and acute pancreatitis patients were 13.01-29.64 nmol/L (mean 18.16), 0.95-11.81 nmol/L (mean 6.52), and 9.64-25.0 nmol/L (mean 13.61), respectively. Mean neopterin levels in pancreatic cancer and acute pancreatitis patients were higher than the accepted norm (norm<10 nmol/L). Serum neopterin concentrations in patients with chronic pancreatitis remained within the norm. CONCLUSIONS: In our opinion, neopterin might be a promising factor of differentiation between pancreatic tumors. However, the use of neopterin as a nonspecific tumor marker requires further studies.