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Number of results: 238
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Abstract

The prevalence of vitamin D deficiency in the American and European population is estimated to be extremely high. Although fewer people today suff er from serious health problems related to calcium and phosphate metabolism resulting from vitamin D deficiency, there are more and more studies suggesting that calcitriol may play an important role in the pathogenesis of other diseases in virtually every body system. A growing body of research shows that through its ubiquitously expressed receptor, calcitriol displays potent anti-angiogenic an anti-inflammatory activity. Th is review summarizes recent discoveries regarding these non-classical eff ects of vitamin D and their clinical implications. Data collection focused on the prevention and treatment of ocular diseases as well as on the underlying mechanisms.
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Abstract

Pancreatic ductal adenocarcinoma (PDAC) is characterized by very poor prognosis. It is caused by asymptomatic course of the disease at early stage. Symptomatic PDAC means usually advanced stage of the disease, making radical treatment impossible. Finding of biological PDAC marker could improve PDAC treatment through early diagnosis. In our study, we investigated two adipokines: omentin and chemerin concentration in PDAC, chronic pancreatitis (CP) and healthy individuals. We examined 27 PDAC patients, 10 CP patients and 36 controls. To determine concentration of adipokines we used ELISA immunoenzymatic assay. Level of both adipokines was increased when comparing control group to PDAC patients. Additionally, chemerin concentration in CP group was elevated comparing to control. To evaluate both adipokines as potential PDAC biomarkers we performed ROC analysis. Chemerin (AUC = 0.913) displayed better discriminant ability than omentin-1 (AUC = 0.73). Some authors believe that chemerin may promote tumour growth by stimulating angiogenesis and is supposed to be a factor recruiting mesenchymal stroma cells (MSC) in tumour regions. Omentin-1 can inhibit tumourigenesis by TP53 stimulation. On the other hand, according to some studies, omentin-1 may promote cancer proliferation via Akt signalling pathway. Results from our study showed signifi cantly elevated level of chemerin and omentin-1 in PDAC patients. Th erefore, w e believe that both investigated adipokines may provide promising and novel pharmacological insights for oncological diagnosis in the near future.
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Abstract

Anaphylaxis is an increasing problem in public health. Th e food allergens (mainly milk, eggs, and peanuts) are the most frequent cause of anaphylaxis in children and youth. In order to defi ne the cause of anaphylaxis, skin tests, the determination of the concentration of specifi c IgE in the blood and basophil activation test are conducted. In vitro tests are preferred due to the risk of allergic response during in vivo tests. Component-resolved diagnosis (CRD) is an additional tool in allergology, recommended in the third level of diagnostics when there are diagnostic doubts aft er the above mentioned tests have been carried out. The paper presents 3 cases of patients with anaphylactic response, and the application of CRD in these patients helped in planning the treatment. Patient 1 is a 4-year-old boy with diagnosed atopic dermatitis and bronchial asthma reported an anaphylactic shock at the age of seven months caused by cow’s milk and the exacerbation of bronchial asthma aft er eating some fruit. Patient 2 is a 35-year-old woman who has had anaphylactic shock three times: in June 2015, 2016, and 2017 and associates these episodes with the consumption of dumplings with a caramel, bun, and the last episode took place during physical exertion few hours aft er eating waffl e. Patient 3 is a 26-year-old man with one-time loss of consciousness after eating mixed nuts and drinking beer. CRD off ers the possibility to conduct a detailed diagnostic evaluation of patients with a history of anaphylactic reaction.
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Abstract

T h e a i m: The aim of the study is to present the initial experience with continuous flow left ventricle assist device (CF-LVAD) in pediatric patients with BSA below 1.5 m2. M a t e ri a l a n d M e t h o d s: Between 2016 and 2017, CF-LVAD (the Heartware System) have been implanted in three pediatric patients in the Department of Pediatric Cardiac Surgery, Jagiellonian University, Krakow, Poland. The indications for initiating CF-LVAD were end-stage congestive heart failure due to dilated cardiomyopathy in all children. R e s u l t s: Implanted patients have had BSA of 1.09, 1.42, 1.2 m2, and 37, 34, 34 kg of body weight and the age 12, 11, 12 years, respectively. The time of support was 550 days in two patients and 127 in another one, and is ongoing. The main complication has been driveline infection. C o n c l u s i o n: The outcomes from our single-center experience using the HeartWare CF-LVAD have been excellent with a low incidence of complication and no necessity to reoperation in our patients. Children could be successfully and safely discharged home.
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Abstract

B a c k g r o u n d: A novel paradigm of diastolic heart failure with preserved ejection fraction (HFpEF) proposed the induction of coronary microvascular dysfunction by HFpEF comorbidities via a systemic pro-infl ammatory state and associated oxidative stress. Th e consequent nitric oxide deficiency would increase diastolic tension and favor fi brosis of adjacent myocardium, which implies not only left ventricular (LV), but all-chamber myocardial stiff ening. Our aim was to assess relations between low-grade chronic systemic infl ammation and left atrial (LA) pressure-volume relations in real-world HFpEF patients. Me t h o d s: We retrospectively analyzed medical records of 60 clinically stable HpEFF patients in sinus rhythm with assayed high-sensitive C-reactive protein (CRP) during the index hospitalization. Subjects with CRP >10 mg/L or coexistent diseases, including coronary artery disease, were excluded. LV and LA diameters and mitral E/E’ ratio (an index of LA pressure) were extracted from routine echocardiographic 46 Cyrus M. Sani, Elahn P.L. Pogue, et al. records. A surrogate measure of LA stiff ness was computed as the averaged mitral E/e’ ratio divided by LA diameter. R e s u l t s: With ascending CRP tertiles, we observed trends for elevated mitral E/e’ ratio (p <0.001), increased relative LV wall thickness (p = 0.01) and higher NYHA functional class (p = 0.02). Th e LA stiffness estimate and log-transformed CRP levels (log-CRP) were interrelated (r = 0.38, p = 0.003). On multivariate analysis, the LA stiff ness index was independently associated with log-CRP (β ± SEM: 0.21 ± 0.07, p = 0.007) and age (β ± SEM: 0.16 ± 0.07, p = 0.03), which was maintained upon adjustment for LV mass index and relative LV wall thickness. C o n c l u s i o n s: Low-grade chronic infl ammation may contribute to LA stiff ening additively to age and regardless of the magnitude of associated LV hypertrophy and concentricity. LA stiff ening can exacerbate symptoms of congestion in HFpEF jointly with LV remodeling.
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Abstract

Introduction: Acute subdural hematoma (aSDH) removal is one of the most commonly performed procedure in neurosurgery. Complications of those surgeries which require reoperation are associated with higher risk of poor treatment outcome. Th erefore we decided to analyse potential factors which might be associated with risk of early reoperation among patients who underwent aSDH surgery. Material and methods: We retrospectively analysed 328 patients treated due to aSDH. From their medical records we obtained detailed medical history. Early reoperation was defi ned as reoperation during the same hospital stay. To determine the potential predictors of early reoperation we used univariate and multivariate logistic regression analyses. Results: A total of 20 (6.09%) patients required early reoperation. Th ose patients had signifi cantly higher International Normalized Ratio (INR) upon admission (1.96 ± 2.55 vs. 1.26 ± 0.50; p <0.01) and signifi cantly higher Prothrombin Time (PT) upon admission (21.84 ± 27.10 vs. 13.40 ± 3.45; p <0.01). In multivariate logistic regression analysis aft er adjustment for all possible confounders higher INR (OR: 1.762; 95% CI: 1.017–22.840; p = 0.045) remained independently associated with higher risk of early reoperation among patients with aSDH. Conclusions: Patients with higher INR and PT upon admission are at higher risk of early reoperation. Higher INR is independently associated with higher risk of early reoperation among patients with aSDH.
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Abstract

Both sarcoidosis and primary Sjögren syndrome (pSS) are multisystem disorders of unknown etiology, which share certain clinical features, making the diff erential diagnosis a real challenge in clinical practice. Several published case reports and case series have posed the question as to whether there is a real association — mimicry between the two diseases or it is just coincidence. We attempt, aft er systematic and comprehensive research of the relevant published literature, to present all those data, clinical or paraclinical, which could be useful in the diagnostic approach and the distinguishment of the two diseases. It is certain that, besides the classic diagnostic methods, emerging is the role of immunology and genetics on this direction, although not established yet.
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Abstract

Objective: The goal of this contribution is to present and familiarize the medical community with the method for the assessment of trace and essentials elements in prostate tissue sections. Materials and methods: X-ray fl uorescence based technique (namely Synchrotron Induced X-ray Emission (SRIXE)) is described in terms of methodology, sample preparation and the evaluation of the recorded results (spectral data sets). Materials for the samples were collected from the patients underwent radical prostatectomy due to Adenocarcinoma prostatae. Specimens were freeze-dried, cut by microtome (to the thickness of 15 μm), one slice was placed on Mylar foil (for SRIXE measurements) and adjacent one on microscopic glass (for histopathological assessment). Results: Results presented here show the usability of SRIXE method for the evaluation of concentration of trace and essential elements in prostate tissue sections with the spatial resolution better than 15 microns. Discussion: Histopathological analysis of samples, which is only focused on morphological features, is unable to reveal information about changes in biochemical signature of tissues aff ected by the illness. SRIXE is a powerful and promising technique to analyse even very low concentrations of selected elements at the cellular level without any labelling or separating procedures. Obtained results may be correlated with classic histopathological assessment allowing for drawing conclusions on the changes in certain elements concentrations with the progression of disease. Moreover, mentioned in this work analysis, can be performed for any type of biological tissues.
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Abstract

Background and objective: Urological diseases represent a signifi cant health issue worldwide. Presented study aimed at assessing current urological knowledge and confi dence in performing urological diagnostic and therapeutic procedures among medical students at Jagiellonian University Medical College in Poland and compare it on diff erent stages of the undergraduate medical education. Material and methods: We designed an anonymous survey distributed among Polish students from 1st to 6th year of medical studies, before and aft er clinical urology course. Questions concerned general urological knowledge, prostate diseases, erectile dysfunction, and self-reported practical urological skills. Results: Overall, 437 respondents participated in the survey. Mean total test score in our study groupwas 50.08%, mean general urological knowledge score was 53.44%, mean prostate diseases knowledge score was 55.43%, mean erectile dysfunction score was 36% and mean practical skills score was 45.83%. Mean total test score increased with consecutive years of studies (R = 0.58; p <0.001). Th e risk of an above average total test score was signifi cantly infl uenced by the urology course (OR = 7.95, 95%CI = 1.81–34.84, p = 0.006) and the year of medical studies (4th–6th vs. 1st–3rd) (OR = 5.16, 95%CI = 3.41–7.81, p <0.001). Practical skills score above average was signifi cantly more frequent in the group aft er the urology course (OR = 6.75, 95%CI = 1.54–29.58, p = 0.011). Conclusions: Results of this study reveal low mean scores obtained by students, even aft er completing the urology course, which implies that curriculum requires further development. Urological knowledge and self-assessed practical skills increased with years of medical education. The urology course improved the score obtained in our survey, both in terms of total test score and practical skills.
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