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Bydgoszcz, Poland

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. Source

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. Source

Kolasa K.,Collegium Medicum | Lewandowski T.,Poznan University of Economics
BMC Health Services Research | Year: 2015

Background: Societal preferences have to be taken into consideration to ensure difficult healthcare decisions are legitimate and acceptable. It has been interesting to ascertain whether attitudes towards the principles of public healthcare resources allocation are homogenous. In particular, it has been thought provoking to ask whether advancement in medical technologies, and growing accessibility issues due to scarcity of healthcare resources, have influenced the beliefs of the general public with regard to allocative principles in recent years. The objective of this study was to compare preferences towards the distribution of healthcare resources between younger and older members of society. Methods: Discrete choice experiments using the equivalence of numbers technique and the social welfare function were conducted in Poland. Public preferences towards disease severity, and potential to benefit, as well as aversion to inequity, were elicited. In order to ensure full understanding of questions by the older respondents, a pilot study with ten respondents aged 65+ was conducted. Results: In total, 52 adult respondents (seniors) and 45 students (juniors) were interviewed. While the first were unwilling to trade between different patients, the latter chose a higher number of individuals to compensate for the loss of ten patients with a more severe disease and a higher potential to treat everything else being equal. Juniors were more inequality averse compared to seniors as well. Conclusions: While the revealed preferences of seniors were egalitarian, juniors were more willing to differentiate between disease severity and potential to benefit. Differences in opinion between juniors and seniors should be considered in open dialogue regarding healthcare rationing. Insight into the preferences towards health maximization of the former group and the egalitarian beliefs of the latter group could be useful for decision makers in the search for public acceptance of allocation of scarce healthcare resources. © 2015 Kolasa and Lewandowski. Source

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. Source

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. Source

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