Klinika Endokrynologii


Klinika Endokrynologii

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Slezak R.,Katedra i Zaklad Genetyki Akademii Medycznej | Laczmanski L.,Klinika Endokrynologii | Karpinski P.,Katedra i Zaklad Genetyki Akademii Medycznej | Reszczynska-Slezak D.,Katedra Poloznictwa i Ginekologii WNoZ Akademii Medycznej
Ginekologia Polska | Year: 2011

Objectives: The objective of this study was to investigate the prevalence of common hereditary risk factors for thrombophilia (mutations 1691G>A, 20210G>A and 677C>T variant in factor V Leiden (FV), prothrombin (FII) and MTHFR gene, respectively) - in a cohort of women with early pregnancy loss. Material and methods: Frequency of mutations in FV, FII and MTHFR was assessed by PCR-RFLP or minisequencing in a cohort of 313 women with a history of at least two miscarriages and the control group consisting of 200 women without obstetric complications. Results: Compared with controls, neither FV mutation (3.2% vs 3%; p=0.45) nor the MTHFR 677TT variant (8.4% vs 11.1%; p=0.58) was more prevalent in the patients. Mutation in FII gene was more frequent in the patients (3.5% vs 0.5%; p=0.03) when compared with controls, however, the frequency of this mutation in controls was lower than estimated frequency in the population. © Polskie Towarzystwo Ginekologiczne.

Chmiel-Perzynska I.,Katedra i Z aklad Medycyny Rodzinnej | Derkacz M.,Klinika Endokrynologii | Kowal A.,Studenckie Kolo Naukowe Badan Epidemiologicznych przy | Grywalska E.,Studenckie Kolo Naukowe Badan Epidemiologicznych przy
Family Medicine and Primary Care Review | Year: 2010

Background. OTC (over the counter) market is divided into two groups: drugs sold without a prescription and products without the status of drugs, which include inter alia mineral-vitamin preparation which have the status of dietary supplements. Material and methods. The study was conducted using the author's questionnaire containing 41 closed questions. The study included 194 individuals, 68 men (35.4%) and 124 (64.6%) women. The average age of the study group was 55.9 ± 13.7 years. 9.4% of respondents had elementary education, 28.1% vocational, 51.6% secondary education and 11% had university degree. Results. All the respondents confirmed purchasing OTC products which were sold without prescription. 92.2% of respondents said they spend monthly below 50 PLN on them. Among the three most frequently purchased OTC products people mentioned: analgesics and antipyretics, medicines for colds and mineral-vitamin preparations. Distribution of factors for the purchase of OTC was similar in all subgroups, regardless of education level of subjects. Among the factors to purchase them, respondents most commonly mentioned the recommendation of a pharmacist - 37.6%, continuous use of medicine - 23.2%, use of OTC by the family or friends - 16.5%, a price promotion - 8.8% and advertising - 6.7%. The decision of buying the OTC products was undertaken after consulting the doctor only by 3.1% of the respondents. Information on the preparation of OTC respondents mostly received from the pharmacist - 49% of respondents. Less frequently mentioned as a source of information were: family - 17%, friends - 11.9%, advertising, and flyers - up to 11.3%. Only 6.8% of those surveyed said they had knowledge of OTC which derives from the doctors. Conclusions. The use of OTC drugs is widespread. Doctors should have adequate knowledge of the OTC, and take into consideration using of these products by their patients. Patients should be properly educated about the rules concerning safe use of OTC products. © Wydawnictwo Continuo.

Tercjak M.,Studenckie Kolo Naukowe Przy Klinice Pediatrii | Luczynski W.,Klinika Pediatrii | Wawrusiewicz-Kurylonek N.,Klinika Endokrynologii | Bossowski A.,Klinika Pediatrii
Pediatric Endocrinology, Diabetes and Metabolism | Year: 2010

Both environmental and genetic factors play a role in the pathogenesis of obesity. At present, researchers are examining the genetic background of overweight. Over 100 genes are suspected to influence the obesity. One of those genes is FTO (fat mass and obesity-associated gene). In the manuscript, the relationship between FTO gene polymorphism (AA allele) and overweight, obesity and their consequences are discussed. It was proved, in studies on large number of people, that FTO gene polymorphism is related to higher body mass index, weight and abdominal circumference. Some authors showed that FTO gene polymorphism influences the food intake, energy expanditure and insulin resistance. The expression of FTO gene product was noticed in both, the peripheral as well as central nervous system (hypothalamus). It is possible that FTO gene product is involved in the DNA and RNA reparation and other metabolic processes, however, its function is not yet clear. The assessment of FTO gene polymorphism can allow us to separate patients with the tendency for higher weight. The elucidation of the role of FTO in the pathogenesis of obesity can result in the development of new therapeutic options for this epidemic of XXI century.

Michalak R.,Klinika Endokrynologii | Zieleniewski W.,Klinika Endokrynologii
Family Medicine and Primary Care Review | Year: 2011

Background. There is an increasing interest in vitamin D role in human health. Vitamin D insufficiency is associated not only with osteoporosis and risk of fractures but also with cardiovascular, autoimmune diseases, metabolic syndrome, obesity and cancer. Material and methods. Retrospective analysis of case history of 198 patients (154 females and 44 males) admitted to the Department of Endocrinology of Medical University of Lodz in 2010. Serum level of vitamin D was taken routinely. Results. Vitamin insufficiency was found in 88% of both males and females group. In 52% serum level of vitamine D was lower than 10 ng/ml and in 36% lower than 20 ng/ml. Conclusion. Vitamin D insufficiency is a very common problem in Poland and needs proper management especially by family medicine specialists. © Copyright by Wydawnictwo Continuo.

Lebkowska A.,Klinika Endokrynologii
Pediatric endocrinology, diabetes, and metabolism | Year: 2010

Polycystic ovary syndrome (PCOS) affects 4-7% women in reproductive age. Insulin resistance and hiperinsulinemia are considered as main pathogenic factors. According to the published studies, PCOS is also prevalent in type 1 diabetes mellitus. In this review we present the potential mechanisms involved in pathogenesis of PCOS in type 1 diabetes mellitus.

Rabijewski M.,Klinika Endokrynologii | Zgliczynski W.,Klinika Endokrynologii
Przeglad Menopauzalny | Year: 2010

Aging in men is accompanied by gradual decline of all physiological functions, involving the heart, lungs, kidneys, liver and brain as well as the endocrine systems. The symptomatology is characterized by a decrease in general well-being, work capacity, muscle mass and strength, virility, sexual pilosity, libido and sexual activity, by a greatly increased frequency of impotence, increased body fat, osteopenia and atherosclerosis, and a decline in cognitive performance, forgetfulness and sleep disturbances. Many of these symptoms are reminiscent of symptoms of hormone deficiency such as hypogonadism, growth hormone (GH), deficiency or hypothyroidism, although it often remains difficult to evaluate the relative contribution of the aging process itself, the endocrine alterations or the permanent consequences of previous diseases to the symptomatology in aging males. We present here some reflections on the involvement of the endocrine system in the aging process in men.

Congenital adrenal hyperplasia (CAH) is an inherited metabolic disorder affecting physical and psychosexual development connected with endocrine disturbances. THIS STUDY AIMED: to assess the physical development of children treated for CAH and to analyze their psychological and social problems in their parents' opinion. The subjects were 20 children with CAH (aged 4.5-19 years, 7 girls and 13 boys) and their parents. The research was based on a retrospective analysis of subjects' development and a questionnaire for parents asking about their emotional reactions to diagnosis, concerns and expectations, knowledge about CAH as well as gender assignment of their children. The parents asked about their emotional reaction to diagnosis of CAH reported anxiety (60%) and helplessness (40%). About 40% of the parents were worried about further sexual life of their children. Most of the parents were satisfied with the way they were informed about CAH, nevertheless about 15% didn't fully understand the matter of this disorder. Over 60% of the parents searched for additional information about CAH. CAH-affected children aged <12 years were higher than healthy children, but they didn't exceed 50th percentile of height after 12th year of life. During the developmental period, the difference between the height of healthy children and those with CAH increased, children with CAH were smaller. Their BMI was between the 90th and 97th percentile both in girls and boys. Questioned parents noticed that CAH-affected girls preferred boy's toys, sports and plays. Occupational plans of girls with CAH correlated more with a group of healthy and CAH-affected boys than with healthy girls. The parents emphasized the importance of support groups for children with CAH and complained of lack of satisfying psychological support. Physical development of children with CAH is characterized by specific problems. Quick confirmation of final diagnosis and complex genetic counseling allow to introduce proper pharmacological treatment and social and psychological support, The essential issue is to improve parents' education about CAH and provide support groups for families of CAH-affected children.

Changes in the structure and functioning of the body occur with age. Also nutrition is continually modified. Eating habits may affect favorably or unfavorably on the process of aging and the functioning of various tissues, organs and the whole body. The purpose of the study was to evaluate dietary habits and food preferences of patients in different age groups. In the studied groups also body mass index (BMI) and body fat content were analyzed. 237 people (133 women and 104 men, age 18-79 years) were examined. The participants completed questionnaires of the frequency of food consumption and food preferences. The height, weight, body mass index (BMI), the percentage of body fat (BIA) were also measured. For statistical analysis the assessment of correlation Spearman's rank order and nonparametric ANOVA rank Kruskal-Wallis were used. With age, the frequency of milk (p < 0,05) and cheese (p < 0,05) consumption decreased whereas consumption of cottage cheese increased (p < 0,05). Increased consumption of offal (p < 0,05), salt (p < 0,05) and coffee (p< 0, 05) was also noted. With age, the respondents preferred animal fats (p < 0.05) and vegetable fats (p < 0.05). The frequency of butter consumption decreased (p < 0.05) and consumption of vegetable fats increased (p < 0,05). The consumption of brown rice (p < 0,05), whole wheat pasta (p < 0,05) and cereals (p < 0,05) was reduced whereas the consumption of groats (p < 0,05) potatos (p < 0,05) and fruits (p < 0,05) increased. The decreased desire (p < 0,05) and frequency of nuts / almonds consumption (p < 0,05) were noted. With age, the BMI and percentage of body fat were increasing (p < 0,05, R = 0,39, p < 0,05, R = 0,31, respectively). Taste preferences and dietary habits vary depending on age and may be one of the elements affecting the increase in BMI, body fat content, bone mass loss and increased risk of metabolic disorders. The observed changes in dietary habits can contribute to the development of dyslipidemia, glucose dysmetabolism and arterial hypertension, especially in the presence of overweight and obesity.

Chromogranin A (CgA) is regarded as a major, nonspecific neuroendocrine tumour (NET) marker. The results of CgA blood concentration, however, may actually be influenced by various factors or coexisting pathological conditions. Among the factors causing a substantial increase of the blood CgA concentration are: treatment with proton-pump inhibitors or H2 -receptor blockers, chronic atrophic gastritis (type A), impaired renal function, prostate cancer and BPH, and rheumatoid arthritis with high level of RF IgM. In addition, the sort of investigated biological material (whether it is serum or plasma) is of importance. There are also many conditions which may have a moderate or little influence on the concentration of CgA, among them are: inflammatory bowel disease (ulcerative colitis and Crohn's disease), deteriorating liver function, untreated essential hypertension, heart failure, hypercortisolism, pregnancy, and, in some subjects, ingestion of a meal. Proper assessment of the CgA results requires detailed knowledge about various factors, drugs, and pathological conditions influencing its concentration in blood.

Most medical agents currently applied in osteoporosis therapy act by inhibiting bone resorption and reducing bone remodelling, i.e. they inhibit the process of bone mass loss by suppressing bone resorption processes. These drugs provide an ideal therapeutic option to prevent osteoporosis progression. They however have a rather limited usefulness when the disease has already reached its advanced stages with distinctive bone architecture lesions. The fracture risk reduction rate, achieved in the course of anti-resorptive therapy, is insufficient for patients with severe osteoporosis to stop the downward spiral of their quality of life (QoL) with a simultaneously increasing threat of premature death. The activity of the N-terminal fragment of 1-34 human parathormone (teriparatide - 1-34 rhPTH), a parathyroid hormone (PTH) analogue obtained via genetic engineering , is expressed by increased bone metabolism, while promoting new bone tissue formation by stimulating the activity of osteoblasts more than that of osteoclasts. The anabolic activity of PTH includes both its direct effect on the osteoblast cell line, and its indirect actions exerted via its regulatory effects on selected growth factors, e.g. IGF-1 or sclerostin. However, the molecular mechanisms responsible for the actual anabolic effects of PTH remain mostly still unclear. Clinical studies have demonstrated that therapeutic protocols with the application of PTH analogues provide an effective protection against all osteoporotic fracture types in post-menopausal women and in elderly men with advanced osteoporosis. Particular hopes are pinned on the possibility of applying PTH in the therapy of post-steroid osteoporosis, mainly to suppress bone formation, the most important pathological process in this regard. The relatively short therapy period with a PTH analogue (24 months) should then be replaced and continued by anti-resorptive treatment.

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