Fast and simple analysis of the content of Zn, Mg, Ca, Na, and K in selected beverages widely consumed by athletes by flowing liquid cathode atmospheric pressure glow discharge optical emission spectrometry.

An atmospheric pressure glow discharge (APGD) system, generated between a flowing liquid cathode (FLC) and a gas (He) jet anode, was applied for the determination of Zn, Mg, Ca, Na, and K in selected beverages commonly chosen by athletes (namely Coca-Cola Zero, energy and vitamin drinks, pre-workout, branched-chain amino acids, almond drink, and whey protein) by optical emission spectrometry (OES). In some cases (i.e., Coca-Cola, energy drink, and almond drink), sugared and sugar-free versions of the beverages were analyzed with the purpose of establishing the impact of added sugar on the analyte signal intensities. The analysis was performed after a simplified sample preparation procedure, which involved only their dilution and acidification with HNO3 to a concentration of 0.2 mol L-1. To determine the most suitable conditions for performing the analysis, optimization of the crucial operating parameters and sample dilution was carried out. Under the compromise conditions, the instrumental detection limits (DLs) were established and found to be 21, 0.91, 20, 0.062, and 0.14 µg L-1 for Zn, Mg, Ca, Na, and K, respectively. Due to the relatively low detection limits, the analyte content could be determined for a fairly high dilution, being concurrently the same for all analytes, which further simplified the whole procedure. It was found that the vast majority of samples could be determined using external calibration with simple standard solutions. The standard addition technique used for calibration was only required for the determination of Mg in three samples. The analysis results were consistent (in the majority of cases the recovery values were in the range of 88-111%) with the values obtained for the reference method (inductively coupled plasma optical emission spectrometry, ICP-OES), which proved the reliability of the results obtained from the developed FLC-APGD-OES system.

Nutrition Disturbances and Metabolic Complications in Kidney Transplant Recipients: Etiology, Methods of Assessment and Prevention-A Review.

Nutrition disturbances occur at all stages of chronic kidney disease and progress with the decrease of the kidney filtration rate. Kidney transplantation (KTx) as the best form of kidney replacement therapy poses various nutritional challenges. Prior to transplantation, recipients often present with mild to advanced nutrition disturbances. A functioning allograft not only relieves uremia, acidosis, and electrolyte disturbances, but also resumes other kidney functions such as erythropoietin production and vitamin D3 metabolism. KTx recipients represent a whole spectrum of undernutrition and obesity. Since following transplantation, patients are relieved of most dietary restrictions and appetite disturbances; they resume old nutrition habits that result in weight gain. The immunosuppressive regimen often predisposes them to dyslipidemia, glucose intolerance, and hypertension. Moreover, most recipients present with chronic kidney graft disease at long-term follow-ups, usually in stages G2-G3T. Therefore, the nutritional status of KTx patients requires careful monitoring. Appropriate dietary and lifestyle habits prevent nutrition disturbances and may improve kidney graft function. Despite many nutritional guidelines and recommendations targeted at chronic kidney disease, there are few targeted at KTx recipients. We aimed to provide a brief review of nutrition disturbances and known nutritional recommendations for kidney transplant recipients based on the current literature and dietary trends.

Association of Physical Performance, Muscle Strength and Body Composition with Self-Assessed Quality of Life in Hemodialyzed Patients: A Cross-Sectional Study.

(1) Patients on chronic hemodialysis (HD) experience impaired quality of life (QoL). We analyzed HD's relationship with physical performance, body composition, and muscle strength; (2) QoL was assessed with the Short Form-36, composed of physical (PCS) and mental (MCS) health dimensions. Physical performance was assessed with the Short Physical Performance Battery (SPPB), body composition (lean tissue mass% (LTM%), fat tissue mass% (FTM%), and skeletal muscle mass% (SMM%)) was assessed with bioelectrical impedance, and lower extremity strength was assessed with a handheld dynamometer; and (3) we enrolled 76 patients (27 F, 49 M), age 62.26 ± 12.81 years, HD vintage 28.45 (8.65−77.49) months. Their QoL score was 53.57 (41.07−70.64); their PCS and MCS scores were 52.14 (38.69−65.95) and 63.39 (44.64−76.79) and strongly correlated (p < 0.0001, R = 0.738). QoL correlated positively with SPPB (R = 0.35, p ≤ 0.001), muscle strength (R from 0.21 to 0.41, p < 0.05), and LTM% (R = 0.38, p < 0.001) and negatively with FTM% (R = −0.32, p = 0.006). PCS correlated positively with SPPB (R = 0.42 p < 0.001), muscle strength (R 0.25−0.44, p < 0.05), and LTM% (R = 0.32, p = 0.006) and negatively with FTM% (R = −0.25, p = 0.031). MCS correlated positively with SPPB (R = 0.23, p = 0.047), SMM% (R = 0.25; p = 0.003), and LTM% (R = 0.39, p < 0.001) and negatively with FTM% (R = −0.34; p = 0.003). QoL was unrelated to sex (p = 0.213), age (p = 0.157), HD vintage (p = 0.156), and BMI (p = 0.202); (4) Better physical performance, leaner body composition, and higher muscle strength are associated with better mental and physical QoL in HD.

Respiratory distress syndrome in preterm infants: possible impact of surfactant application techniques.

OBJECTIVES: Prematurity is one of the most important issues in perinatology. The most frequent postnatal pathology connected with prematurity is respiratory distress syndrome (RDS) caused by surfactant deficiency due to lung immaturity. RDS is one of the most frequent causes of mortality and morbidity with short- and long-term consequences. The aim of the study was to compare the effectiveness of individual surfactant supply techniques in the treatment of respiratory disorders in premature infants. MATERIAL AND METHODS: In the period from the year 2009 to 2013, there were 198 very premature infants that received surfactant included to this retrospective study. They were divided into three groups based on the surfactant application method: Premature newborns with substitute ventilation, with supply of surfactant through a traditional endotracheal tube - Average gestational age 26.6 weeks; Mean birth weight 911 g; Average Apgar score 4 in 1st minute, 6 in 5th minute. Premature newborns with exogenous surfactant supplementation - InSure method - Average gestational age 28.3 weeks; Average birth weight 1117 g; Mean Apgar score 6 in 1st minute, 7 in 5th minute. Premature newborns with exogenous surfactant supplementation - Less Invasive Surfactant Administration (LISA) method - Mean gestational age 29.9 weeks; Average birth weight 1444 g; Average Apgar score 7 in 1st minute, 8 in 5th minute. RESULTS: Noninvasive methods of respiratory support and minimally invasive surfactant administration (MISA) significantly reduced the incidence of severe RDS, compared to the traditional method. CONCLUSIONS: Non-invasive methods of respiratory support and MISA like LISA and InSure methods were safe and effective in the treatment of RDS.

Application of atmospheric pressure glow discharge generated in contact with liquids for determination of chloride and bromide in water and juice samples by optical emission spectrometry.

Novel atmospheric pressure glow discharge (APGD) microplasma systems, sustained between a miniaturized flowing anode (FLA) or cathode (FLC) and a He jet, were investigated for the direct determination of Br and Cl, using optical emission spectrometry (OES). The impact of the most crucial operating parameters, i.e., the acid type and its concentration, the discharge current, the gas flow rate, and the sample flow rate, was studied for each of the proposed APGD-based systems. Under the optimized conditions, the analytical figures of merit were determined. The susceptibility to the matrix effects of both developed methods was verified as well. It was found that the mechanism of the analytes transport into the discharge likely relied on the cathode sputtering in the case of FLC-APGD and the formation of the volatile Br and Cl species for FLA-APGD. The DLs of Br and Cl were established to be relatively high, i.e., 0.15 and 1.5 mg L-1 for FLA-APGD and 2.1 and 18 mg L-1 for FLC-APGD. However, both studied methods turned out to be resistant to the presence of foreign ions in a sample, at relatively high concentrations. Hence, the proposed methods could be successfully applied for the determination of Br and Cl in water and juices samples and no major differences between the results obtained using the external standard calibration and the standard addition method were found.

Five years of innovations in development of glow discharges generated in contact with liquids for spectrochemical elemental analysis by optical emission spectrometry.

The newest achievements in the field of glow microdischarges generated in contact with a flowing liquid cathode (FLC) and a flowing liquid anode (FLA), used as the excitation sources for optical emission spectrometry (OES), were summarized herein. The design of recently reported discharge systems was compared and comprehensively discussed. A lot of effort was devoted to evaluate the effect of selected operating parameters, i.e., discharge voltage and current, sample flow rate, sample pH, jet-supporting gas flow rate, and discharge gap, on the microplasma stability and the intensity of measurable analytical signals. Furthermore, the influence of chemical modifiers, i.e., organic acids, alcohols, and surfactants, aimed at improving the sensitivity and reducing matrix effects, was referred to as well. Finally, the analytical performance and the application of these promising excitation sources for the elemental analysis of different-matrix samples were presented.

Comparison of the performance of atmospheric pressure glow discharges operated between a flowing liquid cathode and either a pin-type anode or a helium jet anode for the Ga and In determination by the optical emission spectrometry.

Novel atmospheric pressure glow discharge (APGD) microplasma systems, sustained between a miniaturized flowing liquid cathode (FLC) and either a pin-type anode or a He nozzle jet were investigated for the determination of Ga and In by the optical emission spectrometry (OES). The most influential working parameters, i.e., solution flow rate, acid concentration, discharge current, and He flow rate, were optimized for both studied systems. Furthermore, the effect of the addition of low molecular weight organic compounds (LMWOCs) into the FLC solution on the signals intensity of Ga and In was investigated. Subsequently, the impact of concomitant ions on the signals intensity of Ga and In was thoroughly studied and it was established that both studied methods are relatively resistant to matrix effects. Under the optimized conditions, the detection limits (DLs, assessed on the basis of the 3σ criterion) of the studied elements were similar for both discharges and ranged between 1.8 and 2.3 µg L-1 for Ga and 0.37-0.40 µg L-1 for In. The received DLs were therefore better than those obtained for other spectrometric methods being premised upon microplasma systems and comparable with those obtained by currently employed large-scale instrumentation. The system with the pin-type anode was successfully applied for the Ga and In determination in four leachates of solders and electronic scrap as well as river water, using external calibration with simple standard solutions. The received results were compared to those obtained from ICP-OES or ICP-MS measurements and their recoveries were fallen within the range of 98-114%, confirming the excellent accuracy and reliability of the developed FLC-APGD-OES method.

Adherence to Pharmacotherapy and Lifestyle Recommendations Among Hemodialyzed Patients and Kidney Transplant Recipients.

OBJECTIVE: Success in treatment with hemodialysis (HD) and kidney transplantation (KTx) requires good adherence. The objective of this study was to evaluate adherence to pharmacotherapy and health recommendations among HD and KTx patients using subjective and objective measures. METHODS: Two hundred thirty-nine enrolled patients, with 132 KTx (39F, 93M) and 107 HD (48F, 59M) completed a questionnaire regarding over-the-counter (OTC) medications and dietary supplements (DS), adherence to pharmacotherapy, lifestyle recommendations, and self-evaluation of knowledge on them. The surveys were supplemented with objective data from patients' medical records, including interdialytic weight gain and laboratory parameters. RESULTS: About 42.1% HD and 39.4% KTx patients reported using OTC medications without medical consultation (P = .677); 43.9% HD and 31.1% KTx used DS (P = .040); more HD than KTx failed to notify a doctor about it (52.2% vs. 21.4%; P < .001). More HD patients skipped medication doses (33.6% vs. 9.7%; P < .001). About 40.2% HD and 20.5% KTx patients drank alcohol (P < .001), 22.4% HD and 10.5% KTx smoked (P = .013). About 46.7% HD and 66.4% KTx patients limited their caloric intake (P = .002), 73.8% HD and 84.9% KTx limited their salt intake (P = .030). HD patients drank 1.17 ± 0.57 L of fluids daily and KTx drank 2.51 ± 0.67 L (P < .001). In HD patients, interdialytic weight gains positively correlated with dialysis vintage (R = 0.26, P = .02) and fluid (R = 0.28, P = .011) but not salt intake (P = .307). The variability of trough levels of calcineurin inhibitors was unrelated to use of DS or OTC medications. KTx rated their knowledge on recommendations higher compared with HD (mean score 4.0 ± 1.0 vs. 3.7 ± 1.0, P = .040). CONCLUSION: KTx recipients exhibit better adherence and rate their knowledge on recommendations higher than HD patients.

On the coupling of hydride generation (HG) with flowing liquid anode atmospheric pressure glow discharge (FLA-APGD) for determination of traces of As, Bi, Hg, Sb and Se by optical emission spectrometry (OES).

A novel atmospheric pressure glow discharge (APGD) microplasma system, sustained between a miniaturized flowing liquid anode (FLA) and a He jet nozzle cathode, was combined with a hydride generation (HG) technique to improve the determination performance of As, Bi, Hg, Sb, and Se with the aid of optical emission spectrometry (OES). The discharge current, the He flow rate, and the concentrations of HCl and NaBH4 were considered to affect both the HG reaction and the excitation conditions in the discharge, thus they were thoroughly studied. Under the optimized conditions, the detections limits (LODs), assessed on the basis of the 3σ criterion, reached 1.7, 0.85, 0.04, 0.51, and 2.9 µg L-1 for As, Bi, Hg, Sb, and Se, respectively. The HG and transport efficiency for these elements was evaluated to be 88-100%, which is notably better, as compared to their transport efficiency in the conventional FLA-APGD system, without the HG technique. This yielded an improvement of the LODs achievable in this system and, simultaneously, enabled to determine As, Sb, and Se at a level, which is unobtainable with the use of the FLA-APGD system alone. The proposed methodology was then successfully applied for a quantitative determination of the examined elements in wastewater (ERM-CA713) and spiked water samples. The recoveries of the elements added to these waters (at the maximum acceptable levels in drinking water set by the U.S. Environmental Protection Agency) ranged between 81 and 104%, confirming the excellent accuracy, usefulness, and reliability of the developed HG-FLA-APGD technique.

Designer drugs ­ still a threat?

INTRODUCTION: In Poland, an increasing number of psychoactive substances are becoming prohibited by law as psychotropic or narcotic substances, or as new psychoactive substances (NPSs). Owing to the enormous technological possibilities offered by today's science, synthesis of new derivatives of prohibited compounds is no longer a problem. The moment a dangerous substance is outlawed, new designer drugs (in Poland known as 'dopalacze') appear on the market. STATE OF KNOWLEDGE: An amendment to the Act on Counteracting Drug Addiction issued in July 2018 made it possible for the NPS to be considered drugs by law. Synthetic cannabinoids and cathinone derivatives make up the majority of NPSs identified by the authorities in Poland. Synthetic cannabinoids which can, unlike cannabinoid receptor agonists of plant origin, cause death by somatic toxicity, are particularly dangerous. The ability to quickly recognize poisoning with synthetic opioids is crucial, since an antidote reversing the depressive effect of opioids on the respiratory center can be administered. SUMMARY: This work collects the most important and up-to-date information on designer drugs, based on reports and articles published between 2015 and 2019. The covered aspects include: the current definition of designer drugs in relation to the Polish law, their exact division due to the clinical effects they cause and the description of the threats they pose. Emphasis was given to the current situation of the designer drug market in Poland.

Tacrolimus: Influence of the Posttransplant Concentration/Dose Ratio on Kidney Graft Function in a Two-Year Follow-Up.

INTRODUCTION: Tacrolimus (TAC) metabolism rate has the potential to impact graft function after kidney transplantation (KTx). We aimed to analyze the relationship between the early post-KTx TAC C/D ratio (blood trough concentration normalized by total daily dose) and kidney graft function in a 2-year follow-up. METHODS: We retrospectively analyzed data from 101 post-KTx patients at 3, 6, 12, and 24 months after KTx to identify the C/D ratio cutoff value optimal for dividing patients into fast and slow TAC metabolizers. We investigated the relationship between their TAC metabolism rate and graft function. RESULTS: Patients were divided based on the TAC C/D ratio at 6 months after KTx of 1.47 ng/mL * 1 mg. Fast metabolizers (C/D ratio <1.47 ng/mL * 1 mg) presented with significantly worse graft function throughout the whole study period (p < 0.05 at each timepoint) and were significantly less likely to develop good graft function (estimated glomerular filtration rate ≥45 mL/min/1.73 m2) than slow metabolizers. Our model based on donor and recipient age, recipient sex and slow/fast metabolism status allowed for identification of patients with compromised graft function in 2-year follow-up with 66.7% sensitivity and 94.6% specificity. CONCLUSION: Estimating TAC C/D ratio at 6 months post-KTx might help identify patients at risk of developing deteriorated graft function in a 2-year follow-up.

In-situ generation of Ag, Cd, Hg, In, Pb, Tl and Zn volatile species by flowing liquid anode atmospheric pressure glow discharge operated in gaseous jet mode - Evaluation of excitation processes and analytical performance.

The use of flowing liquid anode atmospheric pressure glow discharge (FLA-APGD) operated with the aid of a gaseous jet as an efficient and novel excitation source for optical emission spectrometry (OES) was evaluated in details. Although about 50 elements have been tested by introducing respective standard solutions into a discharge system, only emission lines of Ag, Cd, Hg, In, Pb, Tl and Zn have been identified. In this arrangement, the surface of solution was bombarded by electrons resulting in generation of volatile species of mentioned elements. After penetrating the plasma, they were excited and extraordinary atomic emission was observed for these elements. It was found that the use of the Ar or He jet provided beneficial excitation conditions, while reduction of the discharge gap led to suppression of the intensity of interfering diatomic molecular bands like NO, OH and N2. Under optimal operating conditions of the discharge system, detection limits (DLs) assessed for Ag, Cd, Hg, In, Pb, Tl and Zn were respectively 0.001, 0.006, 0.16, 0.093, 0.076, 0.007 and 0.018 µg L-1, and they were on average by 10-times better as referred to earlier FLA-APGD constructions operated without the gaseous jet. In addition, the discharge was characterized by greater stability and precision of measurements (< 2%). Dynamic ranges of calibration curves covered between 3.5 (Cd, In, Zn) and over 5 orders of magnitude (Ag, Tl). The biggest weakness of the developed system turned out to be high susceptibility to matrix interferences. It was found that presence of foreign ions (at concentrations of 1-10 mg L-1) suppressed emission from studied elements on average by 20-60%. To clarify the reason for extremely high sensitivity of emission lines of Ag, Cd, Hg In, Pb, Tl and Zn, efficiency of transport of these elements from the liquid phase to the plasma was determined. It was established that from 5% to 70% of analytes presented in sample solutions were released, whereas evaporation of water was merely 5-15%. Since the FLA-APGD plasma was enriched with analytes atoms, it was concluded that such processes like electrospray formation or solution evaporation do not make a major contribution to transport of analytes from the liquid phase to the discharge, and that it was mainly due to plasma-induced volatile species generation processes.

In search of optimal psychoactivation: stimulants as cognitive performance enhancers.

An increasing number of people, students in particular, seek substances that improve their cognitive functioning. The most popular group of pharmacological cognitive enhancers (PCEs) are stimulants. Available studies suggest a small beneficial effect of methylphenidate and amphetamine on memory, executive functions, and processing speed. However small, this effect can make the difference between success and failure. In recent years, research has focused on the additional beneficial effect on the emotional state, increased motivation, and placebo-induced cognitive enhancement. This paper briefly reviews the latest and most important research on the relationship between popular stimulants and cognitive enhancement. One cannot understand this relationship without understanding the Yerkes-Dodson law, which explains the relationship between the degree of arousal and performance. It suggests that the effect of stimulants is a dose-dependent continuum. This law has repeatedly been confirmed by studies in which an optimal level of psychoactivation for cognitive enhancement was obtained with low stimulant doses, whereas exceeding the effective dose resulted in cognitive deficits, psychomotor agitation, and addiction. A separate section has been devoted to modafinil, an increasingly popular stimulant that differs from the rest in neurochemical profile and behavioural effects.

Silica-Polymer Composites as the Novel Antibiotic Delivery Systems for Bone Tissue Infection.

Bone tissue inflammation, osteomyelitis, is commonly caused by bacterial invasion and requires prolonged antibiotic therapy for weeks or months. Thus, the aim of this study was to develop novel silica-polymer local bone antibiotic delivery systems characterized by a sustained release of ciprofloxacin (CIP) which remain active against Staphylococcus aureus for a few weeks, and do not have a toxic effect towards human osteoblasts. Four formulations composed of ethylcellulose (EC), polydimethylsiloxane (PDMS), freeze-dried CIP, and CIP-adsorbed mesoporous silica materials (MCM-41-CIP) were prepared via solvent-evaporation blending method. All obtained composites were characterized in terms of molecular structure, morphological, and structural properties by using Fourier Transform Infrared Spectroscopy (FTIR), scanning electron microscopy equipped with energy-dispersive X-ray spectroscopy (SEM/EDX), and X-ray diffraction (XRD), thermal stability by thermogravimetric analysis (TGA) and differential scanning calorimetry (DSC), and in vitro antibiotic release. The antibacterial activity against Staphylococcus aureus (ATCC 6538) as well as the in vitro cytocompatibility to human osteoblasts of obtained composites were also examined. Physicochemical results confirmed the presence of particular components (FTIR), formation of continuous polymer phase onto the surface of freeze-dried CIP or MCM-41-CIP (SEM/EDX), and semi-crystalline (composites containing freeze-dried CIP) or amorphous (composites containing MCM-41-CIP) structure (XRD). TGA and DSC analysis indicated the high thermal stability of CIP adsorbed onto the MCM-41, and higher after MCM-41-CIP coating with polymer blend. The release study revealed the significant reduction in initial burst of CIP for the composites which contained MCM-41-CIP instead of freeze-dried CIP. These composites were also characterized by the 30-day activity against S. aureus and the highest cytocompatibility to human osteoblasts in vitro.

TeleNEN as a telemedicine model for neuroendocrine neoplasm management in case of Meckel's diverticulum NET.

A case of 25- years-old female with NET deriving from Meckel's diverticulum is described. The patient had one year history of dermatological skin problems. Ultrasound examination of abdomen performed because of arterial hypertension, revealed multiple hepatic lesions, which was confirmed in contrast enhanced CT. The typical contrast enhanced metastatic lesions in CT and elevated levels of chromogranin A suggested NET of unknown origin. SRS with 99mTc-HYNICTOC was perform for primary tumor localization, and revealed liver and paraaortic lymph nodes metastases, but no sign of primary tumor location. As a next step for primary tumor localization 68Ga-DOTATATE PET/CT was done, which revealed focus of increased uptake in small intestine considered to be the primary tumor site. The imaging and clinical history of patient was discussed on ENETS Tumor Board. Due to location of primary tumor in the small intestine with no anatomical changes in CT, laparotomy guided with gamma probe after 68Ga-DOTATATE injection was performed. During surgery procedure, the primary tumor was hardly palpable in the tip of Meckel's diverticulum, confirmed by gamma probe. After surgery, tandem peptide receptor radionuclide therapy (PRRT) was started. Patient received 4 doses of 90Y/177Lu-DOTATATE with total activity of 360 mCi (13.32 GBq). The three months follow up 68Ga-DOTATATE PET/CT had shown stable disease of patient. The presented case showed importance role of multidisciplinary team cooperation in patient management. Use of RGS is essential in cases like presented, when the tumor cannot be localized only by surgical palpation.

RSK1 promotes murine breast cancer growth and metastasis.

INTRODUCTION: Triple-negative breast cancer (TNBC), representing over 15% of all breast cancers, has a poorer prognosis than other subtypes. There is no effective targeted treatment available for the TNBC sufferers. Ribosomal S6 kinases (RSKs) have been previously proposed as drug targets for TNBC based on observations that 85% of these tumors express activated RSKs. MATERIALS AND METHODS: Herein we examined an involvement of RSK1 (p90 ribosomal S6 kinase 1) in a regulation of TNBC growth and metastatic spread in an animal model, which closely imitates human disease. Mice were inoculated into mammary fat pad with 4T1 cells or their RSK1-depleted variant. We examined tumor growth and formation of pulmonary metastasis. Boyden chamber, wound healing and soft agarose assays were performed to evaluate cells invasion, migration and anchorage-independent growth. RESULTS: We found that RSK1 promoted tumor growth and metastasis in vivo. After 35 days all animals inoculated with control cells developed tumors while in the group injected with RSK1-negative cells, there were 75% tumor-bearing mice. Average tumor mass was estimated as 1.16 g and 0.37 g for RSK1-positive vs. -negative samples, respectively (p < 0.0001). Quantification of the macroscopic pulmonary metastases indicated that mice with RSK1-negative tumors developed approximately 85% less metastatic foci on the lung surface (p < 0.001). This has been supported by in vitro data presenting that RSK1 promoted anchorage-independent cell growth and migration. Moreover, RSK1 knock-down corresponded with decreased expression of cell cycle regulating proteins, i.e. cyclin D3, CDK6 and CDK4. CONCLUSIONS: We provide evidence that RSK1 supports tumor growth and metastatic spread in vivo as well as in vitro migration and survival in non-adherent conditions. Further studies of RSK1 involvement in TNBC progression may substantiate our findings, laying the foundations for development of anti-RSK1-based therapeutic strategies in the management of patients with TNBC.

Is routine performance of the uterine cervix canal curettage prior to the curettage of the uterine cavity justified?

OBJECTIVES: Endocervical curettage (ECC) together with the dilatation and curettage of the uterine cavity (D & C) is routinely performed in everyday clinical practice. The aim of this study is to assess the rationale of the performance of ECC prior to D & C in indications other than abnormal uterine bleeding (AUB). MATERIAL AND METHODS: Case histories of 736 patients after ECC performed in the 1st Department of Obstetrics and Gynaecology, Medical University of Warsaw, were analyzed retrospectively, the indications for the procedure - age, menopausal status, parity, procedure operator's experience - as well as the result of the histopathology examination were taken into account. Three groups of patients were distinguished based on the indications for the procedure. RESULTS: In 645 (87.6%) of cases normal histopathology results were obtained. 40 (5.4%) cases were abnormal. 31 cases of uterine cervix dysplasia were disclosed (CIN 1-20; CIN 2-5; CIN 3-6), 8 cases of endometrial cancer and 1 case of cancer of the uterine cervix were disclosed. In 51 (7%) of cases tissue material for histopathology examination was not obtained. In patients where ECC and D & C were performed due to indications other than abnormal bleeding from uterine cavity, no abnormal results were revealed. In addition, in this group the highest number of non-diagnostic ECCs was reported (11.59%; p < 0.05). CONCLUSIONS: In the case of endometrial biopsy for indications other than AUB routine ECC prior to D & C need not be performed.

Surfactant administration without intubation in preterm infants with respiratory distress syndrome--our experiences.

BACKGROUND: Surfactant replacement therapy is crucial in the management of respiratory distress syndrome (RDS) in preterm infants. Classic strategies of surfactant administration required intubation. To reduce the need of intubation and mechanical ventilation (MV), we applied surfactant via a thin endotracheal catheter without intubation. PATIENTS AND METHODS: We compared 26 preterm infants threatened by RDS treated with surfactant via a thin endotracheal catheter without intubation (studied group - SG) with a retrospective group of preterm infants managed on MV with early surfactant treatment using INtubation SURfactant Extubation (INSURE) method (control group - CG). Study had an approval from the ethics committee (RNN/6/14/KE). RESULTS: In the SG, 26 preterm infants were treated with one dose of surfactant (Curosurf®) administered via endotracheal catheter without intubation while receiving nasal continuous positive airway pressure (nCPAP)/SiPAP (Infant Flow). After surfactant administration, significantly less patients in SG required intubation and MV (19.2%) versus 65% necessity of second intubation in the CG. The median of time of MV in SG was 5 d versus 3.5 d in CG. Median time spent on nCPAP was 5.5 d versus 4.0 d in CG. The incidence of intraventricular hemorrhage (IVH) in the SG was 53.9%, including 50% with ≥ IVH II versus 36.7% (30% ≥ IVH II) in CG. The incidence of other complications of prematurity in the SG, such as necrotizing enterocolitis was 11.5% versus 23.3% in CG, the hemodynamically important patent ductus arteriosus was observed in 53.9% in SG versus 45% in CG. Bronchopulmonary dysplasia level in SG was significantly lower (15.4%) than in CG (40%), and the incidence of retinopathy of prematurity in SG was also lower (3.9%) versus 11.7% in MV group. CONCLUSION: Surfactant application via a thin endotracheal catheter without intubation seems to be a beneficial therapy for preterm infants with slight and mild degree of RDS. This new method of surfactant application was associated with a lower prevalence of intubation and MV and better pulmonary outcome than implementation of traditional surfactant therapy (INSURE) and MV. Prospective randomized controlled trial is required.