The Impact of Different Types of Diet on the Prevention of Diseases among Polish Inhabitants, Including COVID-19 Disease.

Proper nutrition may help in preventing deaths or at least alleviating the symptoms of many chronic diseases. While the COVID-19 disease was still taking its toll, the world had to adjust to new life conditions, which could change nutritional habits. In this observational, cross-sectional study, we aimed to identify the potential correlations between sociodemographic factors and diet and the presence of common chronic diseases among Polish inhabitants. Furthermore, we tried to determine whether the COVID-19 pandemic led to changes in nutritional habits. Therefore, based on the online study (the National Test for Poles' Health (NTPH), we collected data from 376,102 and 200,000 respondents in two different time frames (before the COVID-19 pandemic: 2019-2020 and during the COVID-19 pandemic: 2021-2022, respectively). Despite the rapid global rise of the COVID-19 pandemic, among our study group, hypertension was still the most commonly occurring disease in both time frames (32.33% in 2019-2020 and 34.95% in 2021-2022, p < 0.001). Furthermore, more chronic diseases were reported during the COVID-19 pandemic than in 2019-2020. Regarding sociodemographic factors, male respondents were more likely to develop hypertension and diabetes (OR = 1.35 CI 95% (1.28-1.43), p < 0.001; and OR = 1.20 CI 95% (1.11-1.30), p < 0.001). Vegetarian diet decreases the likelihood of hypertension, neurological disease, and diabetes (OR = 0.69, CI 95% (0.60-0.81), p < 0.001; OR = 0.72, CI 95% (0.59-0.88), p = 0.001; and OR = 0.73, CI 95% (0.55-0.96), p = 0.026). In line with this, consuming meat meals increases the risk of hypertension (OR = 1.09, CI 95% (1.02-1.17), p = 0.009). Interestingly, a reduced-sodium diet has an association with decreased morbidity of COVID-19 disease (OR = 0.72, CI 95% (0.63-0.82), p < 0.001). This result brings new light to more research to be done to allow efficient prevention of this disease. In conclusion, our study shows the beneficial role of a balanced diet in reducing the incidence rate of common chronic diseases. Our findings may be educational for those who would like to change their nutritional habits and/or for public health professionals to suggest the implementation of proper diets to their patients.

Application and efficacy of transcutaneous electrical acupoint stimulation (TEAS) in clinical practice: A systematic review.

Transcutaneous electrical acupoint stimulation (TEAS) is an emerging therapeutic approach that combines the effects of transcutaneous electrical nerve stimulation (TENS) with acupuncture point stimulation. Due to its noninvasive nature, it possesses relative advantages over traditional acupuncture and needle-based electrostimulation. Despite the large number of randomized clinical trials (RCTs) describing the effectiveness of TEAS in different applications, its role and mechanism are still not fully understood. The aim of this study was to systematically compare and summarize the latest studies examining a variety of TEAS applications in clinical practice. Databases, including Medline (PubMed), Cochrane Library and Google Scholar were searched without any time restrictions (as of March 2021). The analysis was performed according to the Cochrane Collaboration criteria. Out of 637 studies, only 22 RCTs were selected. Nine studies evaluated the impact of TEAS on nausea and vomiting (NV), showing beneficial effects compared to standard therapy. Eight RCTs examined the effectiveness of TEAS in pain management, reporting pain alleviation described using the visual analog scale (VAS) and lowering of total opioid doses. Improvement of postoperative recovery, in vitro fertilization and pregnancy outcomes, as well as display of cardioprotective properties were found to positively correlate with TEAS. As a noninvasive modality with advantages over classical acupuncture and needle-based electrostimulation, TEAS may be a valuable tool in clinical practice, particularly for pain and NV management. However, considering the methodological quality of the RCTs, rigorous large-scale clinical trials are required to evaluate the clinical utility of this method.

Evaluation of the Approach towards Vaccination against COVID-19 among the Polish Population-In Relation to Sociodemographic Factors and Physical and Mental Health.

Due to the rapid development of COVID-19 vaccines, the world has faced a huge challenge with their general acceptance, including Poland. For this reason, we attempted to determine the sociodemographic factors influencing the decision of positive or negative attitudes toward COVID-19 vaccination. The analysis included 200,000 Polish participants-80,831 women (40.4%) and 119,169 men (59.6%). The results revealed that the most common reasons for vaccine refusal and hesitancy were the fear of post-vaccination complications and their safety (11,913/31,338, 38.0%; 9966/31,338, 31.8%). Negative attitudes were observed more often among male respondents with primary or secondary education (OR = 2.01, CI95% [1.86-2.17] and OR = 1.52, CI95% [1.41-1.63], respectively). On the other hand, older age ≥ 65 (OR = 3.69; 95%CI [3.44-3.96]), higher education level (OR = 2.14; 95%CI [2.07-2.22]), living in big cities with a range of 200,000-499,999 inhabitants and more than 500,000 inhabitants (OR = 1.57, CI95% [1.50-1.64] and OR = 1.90, CI95% [1.83-1.98], respectively), good physical conditions (OR = 2.05; CI95% [1.82-2.31]), and at last normal mental health conditions (OR = 1.67, CI95% [1.51-1.85]) were significantly associated with COVID-19 vaccine acceptance. Our study indicates which population group should be further supplied with data and information by health education, the government, and healthcare professionals to alleviate the negative attitude toward COVID-19 vaccines.

The Benefits of the Post-Transplant Cyclophosphamide in Both Haploidentical and Mismatched Unrelated Donor Setting in Allogeneic Stem Cells Transplantation.

Allogeneic hematopoietic cell transplantation (alloHSCT) is a standard therapeutic approach for acute leukemias and many other hematologic malignancies. The proper choice of immunosuppressants applicable to different types of transplantations still requires strict and careful consideration, and data in this regard are divergent. For this reason, in this single-centered, retrospective study, we aimed to compare the outcome of 145 patients who received post-transplant cyclophosphamide (PTCy) for MMUD and haplo-HSCT or GvHD prophylaxis for MMUD-HSCT alone. We attempted to verify if PTCy is an optimal strategy in MMUD setting. Ninety-three recipients (93/145; 64.1%) underwent haplo-HSCT while 52 (52/145; 35.9%) underwent MMUD-HSCT. There were 110 patients who received PTCy (93 in haplo and 17 in MMUD group) and 35 patients received conventional GvHD prophylaxis based on antithymocyte globulin (ATG), cyclosporine (CsA), and methotrexate (Mtx) in the MMUD group only. Our study revealed that patients receiving post-transplant cyclophosphamide (PTCy) show decreased acute GvHD rates and CMV reactivation as well as a statistically lower number of CMV copies before and after antiviral treatment compared to the CsA + Mtx + ATG group. Taking into account chronic GvHD, the main predictors are donor age, ≥40 years, and haplo-HSCT administration. Furthermore, the survival rate of patients following MMUD-HSCT and receiving PTCy with tacrolimus and mycophenolate mofetil was more than eight times greater in comparison to patients receiving CsA + Mtx + ATG (OR = 8.31, p = 0.003). These data taken together suggest that the use of PTCy displays more benefits in terms of survival rate compared to ATG regardless of the type of transplantation performed. Nevertheless, more studies with a larger sample size are required to confirm the conflicting results in the literature studies.

Identification of Factors Affecting the Increased Percentage of CGA Recommendations among Patients on Geriatric Ward.

In Poland, the elderly population is noticeably increasing every year. Therefore, the current healthcare system has to rise to the challenge of treatment and prevention strategies targeting elderly persons. Based on the Vulnerable Elders Survey (VES-13 scale), consisting of international and validated scales, we put effort into identifying the factors affecting the increased percentage of CGA (Comprehensive Geriatric Assessment) recommendations by healthcare system physicians. The study group involved 78 patients from the Department of Geriatrics, Wroclaw Medical University, Poland, aged 60-91 (median Me = 81 years old). Of the studied patients, 51 were recommended for CGA (51/78; 64.6%). A statistically significant association was observed between CGA recommendation and age (p < 0.001); the likelihood of a CGA recommendation increased with age. Furthermore, the increased CGA recommendation was observed among geriatric patients with: (a) frailty syndrome (OR = 11.2, CI95% 2.88-43.5, p < 0.001), (b) high risk of malnutrition or malnutrition (OR = 3.87; CI95%, 1.00-14.9, p = 0.04), (c) low mental status (OR = 3.32, CI95% 1.22-9.09, p = 0.029), (d) low ability to perform basic daily duties (according to ADL scale-OR = 12.6, CI95% 1.57-101, p = 0.004 and IADL scale-OR = 4.71, CI95% 1.72-12.9, p = 0.003), and (e) fall risk (OR = 15.0, CI95% 4.67-48.3, p < 0.001). Moreover, homocysteine levels increased with age (p = 0.003) and decreased with sleep duration (p = 0.043). Taken together, all these factors seem to be important when implementing treatment programs adjusted to the individual geriatric patient.

Transcutaneous electrical acupoint stimulation to reduce opioid consumption in patients undergoing inguinal hernia repair: protocol for a randomized controlled trial.

BACKGROUND: The purpose of this study is to evaluate the efficacy and safety of transcutaneous electrical acupoint stimulation (TEAS) in the postoperative treatment of patients undergoing inguinal hernia repair compared with sham and no treatment group. METHODS: This study is a protocol for a three-armed, single-blinded, placebo-controlled randomized controlled trial. Ninety participants scheduled for inguinal hernia repair will be randomly assigned to the TEAS group (n = 30), sham group (n = 30), and control group (n = 30). The TEAS group will receive treatment using four portable coin-sized electro-stimulators at both local and distal acupuncture points. The sham group will receive sham treatment with mock electrostimulation. The treatment groups will receive mixed frequency stimulation (alternating at 2 and 100 Hz every 3 s) in continuous mode for 30 min at intervals of 2 h for 24 h postoperatively. The control group will receive postoperative pain control using patient-controlled analgesia (PCA) device. The primary outcome is the total morphine dose received in the postoperative period (mg) using PCA 24 h after surgery. The number of PCA demands (i.e., times the button will be pressed) and delivered bolus doses, score on the Visual Analogue Scale, opioid-related side effects, the requirement for supplemental medications, score on the Hospital Anxiety and Depression Scale (HADS), and blood levels of stress hormones cortisol and prolactin. DISCUSSION: The results of this trial will determine whether TEAS with intensified stimulation protocol is a safe and effective option for reducing analgesic consumption and postoperative pain. TRIAL REGISTRATION: ISRCTN76428396. Registered on 05 October 2020. https://www.isrctn.com/ISRCTN76428396.

Sociodemographic and Health-Related Factors Influencing Drug Intake among the Elderly Population.

Excessive drugs intake among the elderly population, including self-medication, constitutes an important public health problem. Polypharmacy may lead to numerous adverse health effects, which become more prevalent when combined with biological changes in seniors. In this cross-sectional study, 500 Polish adults aged ≥60 years (M = 67.9 ± 4.2) were asked to complete a questionnaire via telephone calls, allowing us to identify sociodemographic and health-related factors influencing the daily medications consumption. Our findings revealed that all of the participants were receiving medications; 60.2% of them receive at least 1 to 3 drugs per day (301/500). The most commonly used medications included antihypertensive drugs and analgesics (51.0% and 46.0%, respectively). Taking into account clinical conditions, independent predictors of receiving over 3 medications per day turned out to be (1) coronary artery disease (OR = 6.77; CI 95%, 2.86-16.1), (2) diabetes (OR = 3.23, CI 95%, 1.75-5.95), (3) asthma (OR = 4.87, CI 95%, 2.13-11.1), (4) heart failure (OR = 3.38, CI 95%, 1.59-7.19) and (5) gastroesophageal reflux disease (OR = 1.93, CI 95%, 1.03-3.62). Participants suffering from depression were more likely to take drugs for hypertension (OR = 1.70, CI 95%, 1.04-2.78), while those with anxiety and social loneliness took more painkillers (OR = 2.59, CI 95%, 1.58-4.26 and OR = 2.08, CI 95%, 1.38-3.13, respectively). The most significant sociodemographic factors increasing the drugs intake among the population included in our study were high body mass and subsequent increased BMI values (OR = 2.68, CI 95%, 1.50-4.77). Furthermore, living in a city with over 400,000 inhabitants increased the likelihood of taking antidepressants (OR = 2.18, CI 95%, 1.20-3.94). Our study revealed factors increasing the risk of excessive medications intake and hence, increased susceptibility to some iatrogenic diseases among the elderly population. These factors should be considered by primary care physicians while prescribing appropriate drugs to elderly patients.

Correction: Agrawal et al. The Assessment of Fear of COVID-19 among the Elderly Population: A Cross-Sectional Study. J. Clin. Med. 2021, 10, 5537.

In the original publication [...].

Identification of Barriers Limiting the Use of Preventive Vaccinations against Influenza among the Elderly Population: A Cross-Sectional Analysis.

Older adults are at a high risk of experiencing severe complications of influenza. Receiving a vaccination is a beneficial strategy to prevent the disease and reduce the severity of influenza illnesses. This cross-sectional questionnaire-based study aimed to evaluate the influence of sociodemographic, clinical, and mental parameters as well as other potential risk factors on refusal to vaccinate against influenza among the elderly population in Poland. Furthermore, due to the prevailing COVID-19 pandemic, we put efforts into finding any statistical correlations between the fear of COVID-19 infection in patients and their attitudes toward receiving an influenza vaccination. The study was conducted in November−December 2020 in Poland on a representative nationwide sample of 500 individuals aged > 60. Of the respondents, 62 (12.4%) and 51 (10.2%) underwent influenza vaccination in 2019 and 2020, respectively. Out of ten different factors analyzed in this study, three were significantly associated with attitudes towards influenza vaccination. Participants with net income below the national average of PLN 3000 (OR = 2.37, CI 95% [1.26−4.47]), compared to those earning more than PLN 3000, had significantly higher odds of having a negative attitude towards influenza vaccination. Furthermore, respondents with <174 cm height (OR = 2.56, CI 95% [1.51−4.33]) and those with strong fear of COVID-19 infection (OR = 1.65, CI95% [1.02−2.66]) were also more likely to refrain from influenza vaccination. We believe the identification of factors limiting the willingness to receive influenza vaccination is an effective way to help clinicians focus their efforts on educating the groups of patients with the highest odds of refusing to receive the vaccine. Moreover, it may aid the design and enforcement of national solutions or the implementation of novel legislative measures and preventive programs, increasing public confidence and promoting vaccination, especially among groups at high risk of developing this disease.

BKV Related Hemorrhagic Cystitis-An Insight into Risk Factors and Later Complications-An Analysis on Behalf of Polish Adult Leukemia Group.

BK virus reactivation increases the likelihood of hemorrhagic cystitis (HC) after allogeneic hematopoietic stem cell transplant (HCT). In this study, we aimed to identify predictive and risk factors associated with the increased occurrence of this condition following HCT. On a group of 124 patients aged ≤71 years old (median 40 years) who underwent HCT, we analyzed sex, age, time from diagnosis to transplantation, type of conditioning, donor's relationship, age, and sex, the impact of immunosuppression with different drugs, and acute and chronic GVHD, BK viremia and viruria as potential factors increasing the risk of BK-related HC after HCT. HC occurred among 24 patients (24/124; 29.2%). A significant correlation was observed between HC incidences after HCT, BK viremia and viruria, and acute GVHD occurrence. Furthermore, the level of BKV DNA in serum at day +21 (>0.75 × 103) significantly impacted the patients' survival time. According to our results, the likelihood ratio of BKV-DNA on day +21 in serum is 6.25, indicating that this diagnostic test has the potential to be utilized in a clinical setting. These findings may be used as a voice in the discussion on implementing an optimal preemptive treatment in BKV reactivation after allogeneic HCT.

The Impact of Hypoglycemia on Patients with Diabetes Mellitus: A Cross-Sectional Analysis.

The increasing mortality and morbidity in patients with diabetes mellitus constitute a severe public health problem. The condition is recognized as a cause of impaired quality of life, high costs, and diminished productivity. In this study, we performed a cross-sectional analysis among 300 Polish participants with type 1 and type 2 diabetes to determine and classify risk factors associated with increased incidences of hypoglycemia. Including an open-access knowledge about the correlations between diabetes rates and human's lifestyle, we confirm that the frequency of smoking and drinking alcohol, low BMI, inappropriate diet, low physical activity, lack of vaccination against influenza and pneumococci, and co-existence of other comorbidities such as cardiovascular diseases, thyroid diseases, hyperlipidemia, retinopathy, and asthma elevate the risk of hypoglycemia. Furthermore, hypoglycemic patients were more often malnourished, depressed, irritated, and exposed to stress. In sum, the analysis of the interaction between diabetes and sociodemographic, environmental, or other disease-related risk factors provides strategies to optimize glycemic control and reduce the incidence of hypoglycemia. Furthermore, we believe our findings may constitute a basis for promoting health by adjusting available and implementing new preventive services reducing hypoglycemic episodes in diabetic patients.

How Sociodemographic Factors Impact the Utilization of Recommended Clinical Preventive Screening Services in Poland: A Nationwide Cross-Sectional Study.

Cardiovascular disease (CVD) and cancer are the most frequent causes of mortality in Poland. To date, no study in Poland has attempted to analyze the impact of sociodemographic factors on the utilization of all recommended preventive services for these diseases. To address this challenge, a nationwide cross-sectional study was conducted. One thousand adults aged 18 years or older were interviewed using computer-assisted telephone surveys conducted via random selection. A representative population was obtained in accordance with existing demographics per voivodeship in Poland. We assessed whether factors such as age, gender, body mass index (BMI), net income, household size, place of residence, and education impacted the odds ratio of utilizing recommended preventive services for CVD and cancer. We determined that elderly patients receive influenza vaccination, measure blood pressure, PSA concentration, glucose and lipid profiles, and undergo colonoscopy and mammography more often than younger counterparts. Men were more often influenza vaccinated (OR = 1.56, 95% CI: 1.07-2.27) than women, while women measured blood glucose more often than men (OR = 0.62, 95% CI: 0.42-0.93). Furthermore, net income < 2000 PLN, BMI < 24 kg/m2 and at least secondary education level were found to be crucial predictors of undergoing mammography (OR = 2.16; 95% CI: 1.26-3.72), cervical smear tests (OR = 1.99, 95% CI: 1.24-3.17), and lipid measurements (OR = 1.76, 95% CI: 1.07-2.91), respectively. Educating people and financial support seem to play a crucial role in implementing novel campaigns and preventive programs in Poland. Addressing each significant factor may be of paramount importance in improving the receipt of preventive services and warranting greater preventive care coverage in the Polish population.

The Assessment of Fear of COVID-19 among the Elderly Population: A Cross-Sectional Study.

The prevailing COVID-19 pandemic has dramatically affected the mental health and well-being of individuals. This cross-sectional study aimed to assess the perceived fear of COVID-19 among older adults in Poland and identify subpopulations with the highest risk of potential mental health disorders. The study was conducted in November-December 2020 on 500 people aged ≥60 years (mean M = 67.9, standard deviation SD = 4.2). In order to collect information on participants' characteristics and COVID-19-related information, they were asked to complete a questionnaire based on recorded telephone calls. Perceived fear of COVID-19 was measured using Fear of COVID-19 Scale (FCV-19S), which ranges from 7 to 35. Multiple linear regression was performed to identify factors associated with the perceived fear of COVID-19. Our results showed that the highest level of fear of COVID-19 infection was observed among women (p = 0.025) and patients taking anticoagulants (p = 0.004). Moreover, older adults with higher anxiety levels were more likely to be fearful of COVID-19 (according to the GAS-10 scale; p < 0.001). These findings may help policy makers and healthcare workers to adapt and implement better mental health strategies to help the elderly fight fear and anxiety during the prevailing pandemic.

The Impact of the COVID-19 Emergency on Life Activities and Delivery of Healthcare Services in the Elderly Population.

Due to the prevailing pandemic of the coronavirus disease COVID-19, we are experiencing emotional and social isolation, which negatively affects mental and physical health, particularly among the elderly population. In this study, we performed a cross-sectional analysis based on computer-assisted telephone interviews of 500 Polish adults aged 60 years or older in order to determine the impact of the SARS-CoV-2 pandemic on the older population's behavior, life activity, and delivery of healthcare services. According to our study, COVID-19 infection entailed a substantial change in older people's behavior. Over 50%, nearly 80%, and more than 25% of the surveyed participants reduced their social, recreational, and professional activities, respectively. The most significant change in senior's behavior due to the fear of COVID-19 infection was observed in patients (1) with cardiac and pulmonary problems, (2) being on multi-drug therapy, (3) vaccinated against influenza, and (4) with several mental difficulties including loneliness, social isolation, and depression. Furthermore, we demonstrated that 10% of participants canceled planned hospitalization due to the fear of COVID-19 infection. This was observed primarily in patients suffering from chronic heart and lung diseases, vaccinated against influenza, exhibiting the reluctance to carry out more complex daily activities, and with a higher level of anxiety, social loneliness, and malnutrition. Thus, these groups of seniors require more attention; hence, we propose telemedicine as a strategy directed to them that provides clinical healthcare and information regarding measurements, control, and protection against SARS-CoV-2 during the prevailing COVID-19 pandemic. We believe this strategy may improve treatment outcomes, reduce comorbidities-related complications and unnecessary hospitalizations.

Prevalence of Use of Preventive Services in Poland: Result from a Population-Based Nationwide Study.

Systematic reviews of scientific evidence have identified clinical services that prevent or ameliorate illness and reduce mortality. This study aimed to assess the prevalence of all recommended evidence-based preventive services in a publicly funded healthcare setting. We conducted a population-based nationwide cross-sectional computer-assisted telephone survey of 1000 Polish adults (response rate 42%). The self-reported use of all recommended clinical preventive services was assessed, including mammography, colonoscopy, blood glucose screening, vaccination, blood pressure screening, and preventive counselling. The results showed that only 6.4% of adults had received all recommended preventive screening, whereas only 4.3% had received appropriate counselling. General practitioner (GP) visits, blood pressure screening, blood glucose screening, and cervical smear were among the most commonly provisioned interventions, while flu vaccination, PSA assessment, and preventive counselling were among the least prevalent services. Despite the low uptake of preventive interventions, over 75% is interested in remote access to preventive services using telemedicine platforms and e-consultations. Our findings suggest that there are significant gaps in the receipt of preventive interventions. Further improvements require not only changes in the incentive system for healthcare providers, but also system-level innovation such as telemedicine solutions to deliver preventive services remotely and engage individuals in the monitoring process.

The Effect of a New Glucose-Methotrexate Conjugate on Acute Lymphoblastic Leukemia and Non-Hodgkin's Lymphoma Cell Lines.

Patients with hematologic malignancies require intensive therapies, including high-dose chemotherapy. Antimetabolite-methotrexate (MTX) has been used for many years in the treatment of leukemia and in lymphoma patients. However, the lack of MTX specificity causes a significant risk of morbidity, mortality, and severe side effects that impairs the quality of patients' life. Therefore, novel targeted therapies based on the malignant cells' common traits have become an essential treatment strategy. Glucose transporters have been found to be overexpressed in neoplastic cells, including hematologic malignancies. In this study, we biologically evaluated a novel glucose-methotrexate conjugate (Glu-MTX) in comparison to a free MTX. The research aimed to assess the effectiveness of Glu-MTX on chosen human lymphoma and leukemia cell lines. Cell cytotoxicity was verified by MTT viability test and flow cytometry. Moreover, the cell cycle and cellular uptake of Glu-MTX were evaluated. Our study reveals that conjugation of methotrexate with glucose significantly increases drug uptake and results in similar cytotoxicity of the synthesized compound. Although the finding has been confined to in vitro studies, our observations shed light on a potential therapeutic approach that increases the selectivity of chemotherapeutics and can improve leukemia and lymphoma patients' outcomes.

Phytochemicals in Gynecological Cancer Prevention.

Gynecological cancer confers an enormous burden among women worldwide. Accumulating evidence points to the role of phytochemicals in preventing cervical, endometrial, and ovarian cancer. Experimental studies emphasize the chemopreventive and therapeutic potential of plant-derived substances by inhibiting the early stages of carcinogenesis or improving the efficacy of traditional chemotherapeutic agents. Moreover, a number of epidemiological studies have investigated associations between a plant-based diet and cancer risk. This literature review summarizes the current knowledge on the phytochemicals with proven antitumor activity, emphasizing their effectiveness and mechanism of action in gynecological cancer.

In Vitro and In Vivo Efficacy of a Novel Glucose-Methotrexate Conjugate in Targeted Cancer Treatment.

Methotrexate (MTX) is a commonly used antimetabolite, which inhibits folate and DNA synthesis to be effective in the treatment of various malignancies. However, MTX therapy is hindered by the lack of target tumor selectivity. We have designed, synthesized and evaluated a novel glucose-methotrexate conjugate (GLU-MTX) both in vitro and in vivo, in which a cleavable linkage allows intracellular MTX release after selective uptake through glucose transporter-1 (GLUT1). GLU-MTX inhibited the growth of colorectal (DLD-1), breast (MCF-7) and lung (A427) adenocarcinomas, squamous cell carcinoma (SCC-25), osteosarcoma (MG63) cell lines, but not in WI-38 healthy fibroblasts. In tumor cells, GLU-MTX uptake increased 17-fold compared to unconjugated MTX. 4,6-O-ethylidene-α-D-glucose (EDG), a GLUT1 inhibitor, significantly interfered with GLU-MTX induced growth inhibition, suggesting a glucose-mediated drug uptake. Glu-MTX also caused significant tumor growth delay in vivo in breast cancer-bearing mice. These results show that our GLUT-MTX conjugate can be selectively uptake by a range of tumor cells to cause their significant growth inhibition in vitro, which was also confirmed in a breast cancer model in vivo. GLUT1 inhibitor EDG interfered with these effects verifying the selective drug uptake. Accordingly, GLU-MTX offers a considerable tumor selectivity and may offer cancer growth inhibition at reduced toxicity.

Clinical Characteristics, Preventive Care and Attitude to Telemedicine among Patients with Diabetic Retinopathy: A Cross-Sectional Study.

Diabetic retinopathy (DR) is the most frequent and one of the most severe complications of both types of diabetes. Despite the development of versatile diabetes management programs in most developed countries, many patients remain at increased risk for developing this life-limiting and life-threatening condition. This cross-sectional analysis objective was to examine and compare the prevalence of diabetic retinopathy and comorbidities, as well as the clinical characteristics, prevention patterns, and attitude to telemedicine in patients with diabetes. We found that, when compared to the non-DR group, patients with DR significantly more often utilize clinical preventive services and counseling; however, there is still a significant gap in the receipt of preventative care. Moreover, in the DR subgroup, inadequate diabetic control and the presence of various signs and symptoms of diseases were observed. Although less than a fifth of all patients use mobile applications to monitor their health status, the patients indicate their willingness to use telemedical technology, particularly if it is recommended by the physician and provided without additional costs. The evolution of telemedicine offers a possibility of inexpensive, continuous monitoring of the disease that could improve treatment outcomes. Our observations emphasize DR's perception as a complex disease in which education and continuous monitoring, particularly with telemedicine methods, are critical for further improvement in chronic care.