Kidney Transplantation as a Treatment Option of Chronic Renal Failure Among Lung Transplant Recipients: A Single-Center Experience.

INTRODUCTION: Chronic renal failure is one of the most common complications after solid organ transplantation. It is associated with multiple pre-, peri-, and post-transplant factors. In some patients, the available methods of conservative treatment are insufficient and kidney transplantation (KTx) is necessary. The aim of this study was to present our experience in the treatment of renal failure by KTx after lung transplantation (LTx). METHODS: Our study is a single-center retrospective review of clinical data of all 7 LTx recipients who underwent a KTx between the years 2013 and 2021. Patients' clinical condition, pulmonary function, renal function, and survival were examined. RESULTS: There were a total of 7 patients with medium age 36 years (±15). In 3 patients, the period of time from LTx to KTx was less than 3 years, and in 4 of them less than 13 years. Dialysis therapy was required in 4 patients. One patient had pre-LTx renal disease, while 6 patients had renal dysfunction related to post-transplant factors, including the use of calcineurin inhibitors. CONCLUSIONS: Renal protection is a very important aspect among LTx recipients; therefore, physicians must show a holistic and individual approach to patients and minimize exposure to nephrotoxic medication. Patients at high risk of developing chronic renal failure should be identified and, if required, renal replacement therapy should be initiated, including KTx.

First Successful Pregnancy After Lung Transplantation in Poland-Case Report.

INTRODUCTION: Lung transplantation is well-established treatment for patients with advanced lung dysfunction in cystic fibrosis (CF). Pregnancy in CF lung transplant recipients is feasible, although it still remains challenging for even professionals and demands a multidisciplinary approach. CASE REPORT: We report the case of pregnancy in a 22-year-old woman after lung transplantation (LTx) due to end-stage respiratory failure in the course of CF. The interval from transplant to conception was 2.5 years. In 2019, orthotopic LTx was performed and a 3-drug immunosuppressive scheme was used-tacrolimus, mycophenolate mofetil, and prednisolone. There were no complications in the postoperative course. In April 2022, the patient was confirmed pregnant. All fetotoxic or teratogenic drugs were discontinued. Throughout the whole pregnancy, the patient was regularly monitored in the transplant and obstetrics centers. Due to the vaginal bleeding and irregular contractions at the 33 weeks of pregnancy, the course of steroids was administered. At 38 weeks and 5 days of gestation, she presented premature rupture of membranes. The caesarean section was performed because of breech presentation of the fetus. A live, term daughter was born and according to the screening test she does not have CF. Currently, 12 months after the delivery, the mother's lung function is good. CONCLUSIONS: Getting pregnant and having a safe pregnancy after LTx is possible, but it requires a specialized and individual approach. The patient should be well informed about possible complications and risks including graft failure. The patient's attitude and her cooperation with doctors play a major role.

[Activity of vestibular organs in menopausal women non-users hormone replacement therapy (HRT)]. / Czynnosc narzadu przedsionkowego u kobiet w okresie menopauzy niestosujacych hormonalnej terapii zastepczej (HTZ).

UNLABELLED: Menopause affects women most commonly after 40 years of age. At this time there is higher risk of myocardial infarction, hypertension, high cholesterol level, diabetes, overweight, osteoporosis as well as balance disorders and vertigo. THE AIM OF THIS WORK: was to evaluate the activity of the vestibular organ in menopausal women not using Hormone Replacement Therapy, and then to compare the results with a group of young healthy women. The study involved 100 women aged between 18 and 55 years, qualified into the following study groups: I group (control group)--50 healthy women aged 18-23, II group (study group)--50 menopausal women aged 45-55, not using Hormone Replacement Therapy. METHODS: The study included evaluation of the character and intensity of vertigo, Romberg and Mann test, static posturography, ENG with eyes open and closed, Fitzgerald-Hallpike caloric test, eye-tracking test and optokinetics in all the women. CONCLUSIONS: It was found that menopausal women tend to have central nervous system disorders, peripheral vestibular disorders occur sporddically.

[Does diet affect our mood? The significance of folic acid and homocysteine]. / Czy dieta ma wplyw na nasz nastrój? Znaczenie kwasu foliowego i homocysteiny.

UNLABELLED: In recent years, there has been growing interest in the association between national diet and the possibility of developing various mental disorders, as well as between deficiency of such vitamins as, e.g. folic acid, vitamin B12, B6, and others (e.g., omega-3 fatty acids), elevated serum homocysteine level and the functioning of human brain as well as the occurrence of such disorders as dementia, central nervous system vascular disorders and depression. THE AIM OF THE STUDY: was to present the current state of knowledge about the role of folic acid and homocysteine in the human organism as well as the significance of vitamin deficiency, mainly folic acid and hyperhomocysteinemy for the occurrence of mood disorders. METHOD: The authors conducted the search of the Internet database Medline (www.pubmed.com) using as key words: depression, mood, homocysteine, vitamin deficiencies: folic acid, B6 and 812 and time descriptors: 1990-2007. RESULTS: In depression, folate, vitamins B12 and B6, as well as unsaturated omega-3 fatty acids deficiency affects the biochemical processes in the CNS, as folic acid and vitamin B12, participate in the metabolism of S-adenosylmethionine (SAM), a donator of methyl groups, which play a decisive role in the functioning of the nervous system; they are, among others, active in the formation of neurotransmitters (e.g. serotonin), phospholipids that are a component of neuronal myelin sheaths, and cell receptors. The deficiency of the vitamins in question results in hyperhomocysteinemia (the research shows that approximately 45-55% of patients with depression develop significantly elevated serum homocysteine), which causes a decrease in SAM, followed by impaired methylation and, consequently, impaired metabolism of neurotransmitters, phospholipids, myelin, and receptors. Hyperhomocysteinemia also leads to activation of NMDA receptors, lesions in vascular endothelium, and oxidative stress. All this effects neurotoxicity and promotes the development of various disorders, including depression. Vitamins B12 and B6, folic acid and omega-3 fatty acids supplementation is thus important in patients suffering from their deficiency; national diet as a significant factor in prevention of numerous CNS disorders, including depression, is also worth consideration.

Rapid detection of the SPINK5 polymorphism Glu420Lys by real-time PCR technology.

BACKGROUND: The SPINK5 gene, encoding the serine protease inhibitor LEKTI maps to chromosome 5q32, and has been suggested to be a locus predisposing to atopic diseases in general. The Glu420Lys variant showed significant association with atopy, asthma and atopic dermatitis in recent studies. AIMS OF THE STUDY: Development of a high throughput assay to analyse the polymorphism G1258A (Glu420Lys) in exon 14 of the SPINK5 gene followed by the validation using samples of 235 latex-allergic health care workers (HCWs) with (N=63) and without asthma (N=172), and 80 non-atopic controls. METHODS: Twenty DNA samples were first analysed by a polymerase chain restriction fragment analysis (RFLP) using Hph I to generate defined control DNAs which were used for the development of the assay suitable for the detection of the Glu420Lys variant by LightCycler technology. RESULTS AND CONCLUSIONS: 315 samples were successfully screened with this new assay. The temperatures in the melting analysis of the SPINK5 exon 14 PCR product were characteristic to the probes hybridised to the mutant (AA) at 51.5 degrees C and to the wild-type (GG) at 59.5 degrees C. The fast and reliable mutation detection in the tested samples makes this high-speed method suitable for larger epidemiological studies.

Late preterm infants - impact of perinatal factors on neonatal results. A clinical study.

INTRODUCTION: Infants born between the 34(th) - 36(th) week of pregnancy account for 75% of all preterm infants. Their seemingly slight immaturity is related to serious health problems. OBJECTIVE: The aim of the study was to analyse perinatal factors that influence the occurrence in infants of such problems as respiratory failure, metabolic problems and early onset sepsis (EOS). MATERIALS AND METHOD: The material for the study included all mothers and their late preterm infants: 34+0 - 36+6 born in our hospital (a tertiary referral academic centre) in 2010 and 2011. The course of pregnancy and delivery, the type of delivery, applied preventive measures and treatment, as well as demographic data and the clinical state of infants were all analysed. Data from individual documentation of each mother and infant were collected by 5 designated people and data reliability was independently monitored by a random control of the documentation conducted by the supervising person. RESULTS: A statistically significant relationship between the occurrence of respiratory distress syndrome and infant immaturity, bad state after birth and sepsis in infants were confirmed. Sepsis was more common in the case of vaginal delivery, and coexisted with respiratory distress syndrome. The mother's diseases during pregnancy, a perinatal preventive antibiotic therapy, and possible delivery complications did not influence the infection. Perinatal asphyxia in an infant positively correlated with a Caesarean section and respiratory distress syndrome after birth. CONCLUSIONS: It is necessary to thoroughly establish the type of delivery of a late preterm infant in order to prevent an infection in the newborn child. The improvement of diagnosis of intrauterine hypoxia may reduce the number of Caesarean sections. The decision about late preterm delivery should be based on indices of the mother's state of health. Premature delivery is related to the occurrence of respiratory distress syndrome in a late preterm infant, although the risk is reduced by the application of an antenatal steroid therapy.

Immunosuppressive drugs in dermatology--benefits and threats.

Immunosuppression consists in the breaking of different immune reactions. According to the mechanism of activity, these drugs reveal effects on each stage of the immune process. Among immunosuppressive drugs, steroids, antimetabolites, alkylating agents, cyclosporine, mycophenolate mofetil are used in dermatology. Therapeutic potential of these drugs is limited by dangerous side effects. Apart from inhibition the excessive immunological response to antigens and because of the lack of specific action, they result in total suppression of the immune system. That in turn produces a higher number of infections, an abnormal course of diseases and an increased risk of lymphomas and cancers. Therefore, the decision, on applying any of these immunosuppressive drugs ought to be preceded by thorough analysis of the clinical history, indications and contraindications referring to each drugs and potential toxicity and side effects.

Mycoses--prophylaxis and treatment.

An increase in the mycotic infections has been observed in recent decades. It is the effect of the development of industry, large migrations, living in huge aglomerations, usage of the public swimming-pools, wearing impervious clothes and shoes. Systemic diseases: diabetes, obesity, hormonal disorders, immune and food deficiency, AIDS, neoplasms and prescription drugs: antibiotics, corticosteroids and immunosuppressants, cause mycoses. Mycoses belong to chronic diseases, they are difficult to treat and very often recur. A lot of antimycotic drugs are known, but the most effective are azoles and alliloamines. An intensive research is conducted on introduction of new and more effective and cheaper preparations.

Serum levels of neopterin in patients with lichen planus.

Lichen planus (LP) is a chronic dermatosis whose clinical features include mildly erythematous to violaceous flat-topped, polygonal papules. The etiology of lichen planus is unknown, but it has been postulated that immune mechanism is important. Although it is of importance to monitor the course of immune-mediated diseases, there is a limited number of reliable biomarkers which can be used for lichen planus. Neopterin (NP), a 2-amino-4-hydroxy-(1'2'3'-trihydroxypropyl)-pteridine, is secreted by monocytes and macrophages, mainly as a response to INF-gamma secretion by activated T-lymphocytes. Therefore NP may be a sensitive marker of T-cell mediated immunity. The aim of the presented study was to assess the serum levels of neopterin in patients with lichen planus and to investigate whether serum neopterin levels reflect extensive lesions and progression of this disease. We studied 66 patients with lichen planus who were classified into one of two diagnostic groups: Group I comprised 33 patients with generalized lesions; group II comprised 33 patients with circumscribed lesions. The control group consisted of 30 healthy sex- and age-matched individuals. The serum neopterin concentrations were measured with a commercially available enzyme-linked immunosorbent assay kit. The results of our study are summarized in Table 1. In our study, the serum neopterin levels in the patients with lichen planus classified to group I (9.12 +/- 4.39 ng/mL) and group II (3.80 +/- 0.68 ng/mL) as well as in the whole collection of patients (group I and group II; 6.55 +/- 2.30 ng/mL) were significantly higher than those of the control subjects (2.55 +/- 0.34 ng/mL). Our findings confirm a role for enhanced cellular immunity as well as macrophages activation observed in lichen planus. It seems to us that evaluation of serum neopterin levels, despite the relatively low specificity, reflects extensive lesions and lichen planus progression.