Collegium Medicum

Bydgoszcz, Poland

Collegium Medicum

Bydgoszcz, Poland

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Sikora M.,Nicolaus Copernicus University | Gese A.,Nicolaus Copernicus University | Czypicki R.,Nicolaus Copernicus University | Gasior M.,Nicolaus Copernicus University | And 5 more authors.
Endokrynologia Polska | Year: 2013

Introduction: Dopamine is considered to be crucial for food craving and intake, drug abuse and electrical brain stimulation. Increased levels of dopamine occur after energy intake in the dorsal striatum. In the ventral tagmental area, dopamine is responsible for motivation. There is a natural synaptic dopamine level, and as a result its activity is controlled by density of receptors, amount of released neurotransmitter, and defectiveness of re-uptake by specific transporters. In our study, we wanted to investigate if there is a correlation between mean BMI values and VNTR polymorphisms in SLC6A3 (rs28363170) and DRD4 genes. Material and methods: Chosen gene fragments were amplified using polymerase chain reaction on the DNA template obtained from 506 women. The products of the reaction were electrophoresed and visualised in 3% agarose gel. The genotyping data was analysed with Kruskal-Wallis tests (p < 0.05). Results: In the case of SLC6A3, statistically significant differences in mean BMI were found in the group of obese women (p < 0.05) but not for the whole population of women with normal weight or with overweight (p > 0.05). The mean BMI was higher for the SS genotype than for combined LL and LS genotypes. The difference in mean BMI values for variants of DRD4 was significant for the whole studied population and in the obese group (p > 0.05), and the higher value was correlated with the presence of a variant with seven or more repeats of 48 bp motif. Conclusions: When the two analysed polymorphisms were combined, the spread between the mean BMI values became greater than for single genes. This suggests that the effect on body mass of these two polymorphisms may combine and cause hypo-functionality of the dopaminergic reward system.

PubMed | Collegium Medicum, Medical University of Bialystok, Institute of Rheumatology in Warsaw, Medical University In Poznan And rus Municipal Hospital In Poznan and 4 more.
Type: Journal Article | Journal: Annals of agricultural and environmental medicine : AAEM | Year: 2016

Patients with chronic rheumatoid arthritis (RA) need advice in order to face the problems of everyday life, as well as suffering associated with the disease. Health professionals should attempt to raise the level of resourcefulness and independence of the patient.To assess the relationship between the deficit of knowledge about RA and the degree of pain, fatigue, morning stiffness, assessment of disease activity as well as functional efficiency.The study was conducted on 277 patients with RA in 7 rheumatologic centres in Poland. The method applied was the questionnaire Pol-ENAT (0-156); HAQ DI (0-3); analog scales (0-100).Mean (SD) age was 53.28 (13.01) and disease duration 13.70 (10.63) years. The mean (SD) value was 54.93 (23.17) for pain, 52.97 (21.98) for fatigue, 48.28 (24.76) for morning stiffness (0-100 mm). HAQ DI was 1.40 (0.66), with an upward trend with duration of disease (p<0.001). There was a positive correlation between the demand for knowledge about the movement (r=0.194; p=0.001), self-care (r=0.134; p=0.026), assistance/support(r =0.163; p=0.006) and morning stiffness experienced. There was a negative correlation between the need for knowledge concerning managing pain, feelings and the arthritis process and daily ability assessed with HAQ DI.The study shows that health education should be targeted at young patients with early RA. In the case of the severity of morning joints stiffness, there is a need to increase knowledge about the methods of mobility aids, self-care and the possibility of obtaining support.

Czachowski S.,Collegium Medicum | Piszczek E.,Nicolaus Copernicus University | Sowinska A.,Nicolaus Copernicus University | Olde Hartman T.C.,Roboud University Nijmegen Medical Center
Family Practice | Year: 2012

Background: Patients with medically unexplained symptoms (MUS) are highly prevalent in primary care. There are no guidelines for treatment and management of this group of patients in the Polish health care system and the establishment of a long-term doctor-patient relationship, which is the crux of the therapy, is impeded.Objective. To establish what challenges Polish GPs encounter while dealing with patients with MUS. Method: A thematic analysis of 4 focus groups (14 GPs altogether), using a three-level coding of data. Results: Three main themes surfaced in the analysis: negative emotions among the investigated GPs, their insufficient training in the management of patients with MUS and the lack of guidelines and the influence of the changed health care environment on the management of patients with MUS. Four major influences of the changed health care environment emerged: GPs' negative image as professionals, barriers to building a continuous doctor-patient relationship, limited resources and limited access to specialists and lack of a multidisciplinary primary care team. Conclusions: Treatment and management of patients with MUS should make provision for a personalized approach to the patient within the Polish primary health care system. This can be enhanced by providing additional training in the biopsychosocial model during medical education and establishing a GP multidisciplinary team. Allocating increased financial resources for primary health care and facilitating access to psychologists and psychotherapists could also prove beneficial. © The Author 2011. Published by Oxford University Press. All rights reserved.

Czubak K.,Polish Academy of Sciences | Lewandowska M.A.,Center of Oncology of Poland | Lewandowska M.A.,Nicolaus Copernicus University | Klonowska K.,Polish Academy of Sciences | And 7 more authors.
Oncotarget | Year: 2015

A growing body of evidence indicates that miRNAs may be a class of genetic elements that can either drive or suppress oncogenesis. In this study we analyzed the somatic copy number variation of 14 miRNA genes frequently found to be either over- or underexpressed in lung cancer, as well as two miRNA biogenesis genes, DICER1 and DROSHA, in non-small-cell lung cancer (NSCLC). Our analysis showed that most analyzed miRNA genes undergo substantial copy number alteration in lung cancer. The most frequently amplified miRNA genes include the following: miR-30d, miR-21, miR-17 and miR-155. We also showed that both DICER1 and DROSHA are frequently amplified in NSCLC. The copy number variation of DICER1 and DROSHA correlates well with their expression and survival of NSCLC and other cancer patients. The increased expression of DROSHA and DICER1 decreases and increases the survival, respectively. In conclusion, our results show that copy number variation may be an important mechanism of upregulation/downregulation of miRNAs in cancer and suggest an oncogenic role for DROSHA.

Wlodarczyk Z.,Collegium Medicum | Ostrowski M.,General and Transplantology Surgery | Mourad M.,Cliniques Universitaires Saint Luc | Kramer B.K.,University of Mannheim | And 5 more authors.
Therapeutic Drug Monitoring | Year: 2012

Background: Tacrolimus is a well-established immunosuppressive agent for the treatment and prevention of solid organ graft rejection. It is available as an immediate-release, twice-daily formulation (Tacrolimus BID) and a prolonged-release, once-daily formulation (Tacrolimus QD). In a previous study of the pharmacokinetics (PK) of these formulations, mean systemic exposure [area under the curve from 0 to 24 hours (AUC0-24)] of tacrolimus on day 1 was approximately 30% lower for Tacrolimus QD than for Tacrolimus BID; by day 14, systemic exposure was similar; however, the mean dose of Tacrolimus QD was higher to achieve similar systemic exposure as Tacrolimus BID. Methods: To further compare the PK of the tacrolimus formulations during the first 2 weeks posttransplant, a substudy was performed in a subset of patients enrolled into a phase III trial in de novo kidney transplant recipients comparing Tacrolimus QD and Tacrolimus BID. To minimize the difference in exposure observed in the earlier study, tacrolimus therapy was initiated before transplant. The PK analysis set comprised 34 patients (17 patients per treatment group) who had 4 complete PK profiles and no major PK-related protocol violations. Results: Mean AUC 0-24 of tacrolimus on day 1 was approximately 16% lower for Tacrolimus QD than for Tacrolimus BID, although by day 3 onward, the exposure was similar between treatment groups. Analysis of dose-normalized AUC0-24 (dose normalized to 0.1 mg/kg) showed a similar pattern. There was a good correlation between AUC0-24 and concentration of tacrolimus at 24 hours postdose for both formulations (Tacrolimus QD, r = 0.87; Tacrolimus BID, r = 0.92), and the slope of the line of best fit was similar. Conclusions: These results suggest that initiating tacrolimus therapy before transplant reduces the difference in exposure between Tacrolimus QD and Tacrolimus BID. © 2012 Lippincott Williams & Wilkins.

Lorkowski J.,Central Clinical Hospital of the Ministry of Interior | Nowak W.S.,Collegium Medicum | Nowak W.S.,University of Limerick | Kotela I.,Central Clinical Hospital of the Ministry of Interior | Kotela I.,Jan Kochanowski University
Ortopedia Traumatologia Rehabilitacja | Year: 2014

Hip arthroplasty is widely used in the treatment of osteoarthritis, especially in patients with steroid-induced osteonecrosis of the femoral head. However, this procedure in HIV-seropositive patients has not been described in the Polish literature and is not considered a standard treatment. This paper presents a case study of an HIV-seropositive patient who underwent hip arthroplasty for steroid-induced avascular necrosis of the femoral head without significant complications. Based on this case, we propose an approach to the management of this group of patients. © MEDSPORTPRESS, 2014.

Kolasa K.,Collegium Medicum | Turlej A.,Warsaw University of Technology | Hermanowski T.,Warsaw University of Technology
Przegla̧d epidemiologiczny | Year: 2016

BACKGROUND: In Poland, among other responsibilities, local governments are obliged to organize public health activities for local communities. To fulfill their obligations in this respect, authorities can organize preventive care in the form of health programs. Prior to their implementation, local governments must seek however opinion of the Polish HTA (Health Technology Assessment) agency. HTA recommendations do inform final decision making process but are not obligatory to be followed.OBJECTIVE: Firstly, It was to provide an insight into what extend local governments utilize health programs in their endeavors and the scope of health topics included. Secondly, it was to elicit recommendations for future authors of health programs in order to increase the chances of positive HTA recommendation.METHODS: The retrospective analysis of HTA recommendations issued by the Polish HTA agency (AHTAPol) in 2010 and 2013 was conducted.RESULTS: There were 67 and 294 HTA recommendations issued in 2010 and 2013 respectively of which 47.8% and 34.4% were negative. Among authors, city councils and communes dominated. Vaccinations were the most commonly chosen target health intervention. In total, six key recommendations for local governments interested in the implementation of health programs were elicited.CONCLUSIONS: To increase the chances for positive HTA recommendations, the health program has to be designed for health problems supported by sound clinical evidence which is not covered by the scope of reimbursement offered by National Health Fund. The targeted health intervention has to be supported by the evidence of proven clinical efficacy and safety and utilize available epidemiological data.

Zalewska J.,Klinika Reumatologii i Ukladowych Chorob Tkanki Lacznej | Barczynska T.,Collegium Medicum | Wegierska M.,Collegium Medicum | Jeka S.,Collegium Medicum
Reumatologia | Year: 2012

Systemic lupus erythematosus (SLE) is autoimmune connective tissue disease which leads to multi-system organ failure. The disease is characterized by a variety of symptoms. The presence of gastrointestinal symptoms is often a diagnostic problem, as they may result from the disease, medication side effects, and concomitant diseases of the digestive tract.

Swierszcz J.,Collegium Medicum | Dubiel J.S.,Collegium Medicum | Milewicz T.,Collegium Medicum | Krzysiek J.,Collegium Medicum | And 2 more authors.
Journal of Heart Valve Disease | Year: 2012

Background and aim of the study: Aortic valve stenosis (AVS) and atherosclerosis can be regarded as two manifestations of the same pathological process. The study aim was to evaluate annually the plasma levels of C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor alpha (TNFα) in AVS patients, and to compare these data in AVS patients with and without high IgG, IgM, and IgA titers against Chlamydia pneumoniae. Methods: Sixty patients with AVS who had declined the offer of remedial surgery were allocated to groups according to their antibody titers: group A (n = 30, high IgG titer), group B (n = 30, low IgG titer), group C (n = 22, high IgA titer), group D (n = 38, low IgA titer), group E (n = 7, high IgM titer), and group F (n = 53, low IgM titer) Antibody titers, serum levels of inflammatory markers and echocardiographic scans were monitored at 12-month intervals. Results: During a one-year observation period, a greater number of patients in group A showed AVS deterioration compared to group B (p <0.02). The mean IgA and IgM titers in group A were higher than in group B, while mean serum CRP and IL-6 levels, and IgG titer, tended to be higher in group C compared to group D. No statistically significant differences were identified in mean serum levels of CRP, IL-6, and TNFα between groups A and B. Conclusion: The results of the study suggested a possible association between C. pneumoniae infection and the progression of AVS. © Copyright by ICR Publishers 2012.

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