Agency: European Commission | Branch: FP7 | Program: CP-FP | Phase: HEALTH.2010.3.1-1 | Award Amount: 3.86M | Year: 2011
ODHIN is a Europe wide project involving research institutions from nine European countries that will help to optimize the delivery of health care interventions by understanding how better to translate the results of clinical research into every day practice. ODHIN will use the implementation of identification and brief intervention (IBI) programmes for hazardous and harmful alcohol consumption (HHAC) in primary health care (PHC) as a case study. There is strong evidence for the effectiveness and cost-effectiveness of IBI in reducing HHAC and its consequences, which include more than 60 clinical diagnoses and conditions. A series of systematic reviews investigating the impact of different behavioural, organizational and financial strategies in changing provider behaviour across a range of clinical lifestyle interventions will be undertaken. The knowledge base of potential barriers and facilitators to implementing IBI will be updated. A stepped cluster randomised controlled trial will be undertaken with five arms and three time phases to test the incremental effect of strategies. Phase A will aim at raising awareness, insight, and acceptance of performance of IBI in PHC. Phases B and C will aim at acceptance, change and maintenance of implementation with financial and organisational strategies used in a different order to test the impact of both separately and in sequence. Modelling studies will test the impact of different IBI approaches on changes in alcohol consumption and the resulting impacts on healthcare costs and health-related quality of life. ODHIN will build a clinical evidence-based database on effective and cost-effective IBI measures for use in PHC and will develop a tool to assess the extent of provision of clinical practice. A project website and a series of scientific publications, reports and fact sheets will widely disseminate the documented and evaluated conceptual models across diverse health care settings throughout Europe.
Czaja-Bulsa G.,Pomeranian Medical University |
Czaja-Bulsa G.,Gastroenterology and Rheumatology of The Zdroje Hospital in Szczecin
Clinical Nutrition | Year: 2015
Until recently gluten intolerance has been believed to be typical of celiac disease (CD) and wheat allergy (WA). In the last few years, however, several study results have been published that have proved that gluten intolerance can also affect people who do not suffer from any of the above mentioned diseases. The new syndrome has been named non-celiac gluten sensitivity (NCGS) or gluten sensitivity (GS). It has been included in the new list of gluten-related disorders published in 2012. Researchers believe that NCGS is the most common syndrome of gluten intolerance. This review discusses many aspects of NCGS epidemiology, pathophysiology, clinical spectrum, and treatment and current tools to identify patients suffering from CD, WA, and NCGS. © 2014 The Author.
Zyluk A.,Pomeranian Medical University
Polish orthopedics and traumatology | Year: 2013
In many countries, including Poland, carpal tunnel syndrome is considered to be a disease of possible occupational etiology. This review presents information about work-related risk-factors which comprise the use of handheld vibrating machinery, forceful gripping of objects with hands, repetitive and frequent manual tasks and forced postures of the wrist (flexion/extension). However, the character of the job is only one of possible several factors leading to the development of the disease, as its etiology is multifactorial. Conditions to be taken into consideration when recognizing a case as occupational carpal tunnel syndrome were shown to include: coexistence of predisposing diseases (diabetes), constitutional factors (obesity), character, level and duration of the exposure to harmful stimuli during the workday as well as total duration of work upon exposure. Consideration of these circumstances provides adequate ground for recognizing a particular case as occupational. Nonetheless, even accepting the disease as occupational should be temporary, as surgical carpal tunnel release is an effective method of treatment and should allow the patient to return to previously performed work.
Dolegowska B.,Pomeranian Medical University
Journal of biological regulators and homeostatic agents | Year: 2012
Lipids account for 16-19 percent dry platelet matter and includes 65 percent phospholipids, 25 percent neutral lipids and about 8 percent glycosphingolipids. The cell membrane that surrounds platelets is a bilayer that contains different types phospholipids symmetrically distributed in resting platelets, such as phosphatidylserine (PS), phosphatidylethanolamine (PE), phosphatidylcholine, and sphingomyelin. The collapse of lipid asymmetry is exposure of phosphatidylserine in the external leaflet of the plasma bilayer, where it is known to serve at least two major functions: providing a platform for development of the blood coagulation cascade and presenting the signal that induces phagocytosis of apoptotic cells. During activation, this asymmetrical distribution becomes disrupted, and PS and PE become exposed on the cell surface. The transbilayer movement of phosphatidylserine is responsible for the platelet procoagulant activity. Exposure of phosphatidylserine is a flag for macrophage recognition and clearance from the circulation. Platelets, stored at room temperature for transfusion for more than 5 days, undergo changes collectively known as platelet storage lesions. Thus, the platelet lipid composition and its possible modifications over time are crucial for efficacy of platelet rich plasma therapy. Moreover, a number of substances derived from lipids are contained into platelets. Eicosanoids are lipid signaling mediators generated by the action of lipoxygenase and include prostaglandins, thromboxane A2, 12-hydroxyeicosatetraenoic acid. Isoprostanes have a chemical structure similar to this of prostanoids, but are differently produced into the particle, and are ligands for prostaglandins receptors, exhibiting biological activity like thromboxane A2. Endocannabinoids are derivatives from arachidonic acid which could reduce local pain. Phospholipids growth factors (sphingolipids, lysophosphatidic acid, platelet-activating factor) are involved in tissue regenerating process. Finally, a warning concerning the atherogenic role of platelets, although it should not be exerted in a local therapy, is mentioned. The lipid content of plaletets must be taken into account when these particles are concentrated and used for a local therapy, while the different categories of lipid derivatives could improve or affect the quality of the product.
Huzarski T.,Pomeranian Medical University
Journal of clinical oncology : official journal of the American Society of Clinical Oncology | Year: 2013
To estimate 10-year overall survival (OS) rates for patients with early-onset breast cancer, with and without a BRCA1 mutation, and to identify prognostic factors among those with BRCA1-positive breast cancer. A total of 3,345 women with stage I to III breast cancer, age ≤ 50 years, were tested for three founder mutations in BRCA1. Information on tumor characteristics and treatments received was retrieved from medical records. Dates of death were obtained from the vital statistics registry. Survival curves for the mutation-positive and -negative subcohorts were compared. Predictors of OS were determined using the Cox proportional hazards model. Of the 3,345 patients enrolled onto the study, 233 (7.0%) carried a BRCA1 mutation. The 10-year survival rate for mutation carriers was 80.9% (95% CI, 75.4% to 86.4%); for noncarriers, it was 82.2% (95% CI, 80.5% to 83.7%). The adjusted hazard ratio (HR) associated with carrying a BRCA1 mutation was 1.81 (95% CI, 1.26 to 2.61). Among BRCA1 carriers with a small (< 2 cm) node-negative tumor, the 10-year survival rate was 89.9%. Among BRCA1 mutation carriers, positive lymph node status was a strong predictor of mortality (adjusted HR, 4.1; 95% CI, 1.8 to 8.9). Oophorectomy was associated with improved survival in BRCA1 carriers (adjusted HR, 0.30; 95% CI, 0.12 to 0.75). The 10-year survival rate among women with breast cancer and a BRCA1 mutation is similar to that of patients without a BRCA1 mutation. Among women with a BRCA1 mutation, survival was much improved after oophorectomy.
Slojewski M.,Pomeranian Medical University
Central European Journal of Urology | Year: 2011
The process of crystallization in the urinary tract occurs when the equilibrium between promoting and inhibiting factors is broken. Many theories have been published to explain the mechanism of urinary stones formation; however, none of these theories has paid attention to trace elements. Their role in lithogenesis is still unclear and under debate. The findings of some studies may support the thesis that some major and trace elements may take part in the initiation of stone crystallization for instance as a nucleus or nidus for the formation of the stone, or simply contaminate the stone structure. This review presents a comprehensive account of the basic principles of the basic data and the role of major and trace elements in lithogenesis.
Chudecka-Glaz A.M.,Pomeranian Medical University
Clinica Chimica Acta | Year: 2015
Improvement of survival in ovarian cancer may be achieved through early diagnosis and modification of treatment. Although abnormalities in the adnexal region are frequently observed in transvaginal ultrasound, interpretation may be equivocal in some cases. If neoplastic tumor is suspected, a wide range of tests and algorithms may be applied. Risk of Malignancy Algorithm (ROMA), as first described by Moore in 2009, is one of the most popular approaches. The clinical utility of this regression model has been demonstrated in both pre- (75.6% sensitivity and 74.8% specificity) and post-menopausal (92.3% sensitivity and 74.7% specificity) women. These findings have been independently confirmed in a number of publications. The sensitivity and specificity of ROMA may, however, be improved with inclusion of supplemental data, such as age and ultrasound findings. Because of its simplicity, ROMA is a reliable tool characterized by high accuracy and reproducibility to stratify patients into a high or a low ovarian cancer risk. © 2014 Elsevier B.V.
Machalinska A.,Pomeranian Medical University
Investigative ophthalmology & visual science | Year: 2013
Retinal degenerative diseases targeting the RPE and adjacent photoreceptors affect millions of people worldwide. The field of stem cell- and gene-based therapy holds great potential for the treatment of such diseases. The present study sought to graft genetically engineered mesenchymal stem cells (MSCs) that continuously produce neurotrophin-4 (NT-4) into the murine eye after the onset of acute retinal injury. C57BL/6 mice were subjected to acute retinal damage using a low dose of sodium iodate (20 mg/kg of body weight), followed by intravitreal injection of lentivirally modified MSC-NT-4 into the right eye. At 3 months after the MSC transplantation grafted cell survival, retinal function and gene expression were analyzed. Immunofluorescence analysis confirmed that transplanted MSCs survived for at least 3 months after intravitreal injection and preferentially migrated toward sites of injury within the retina. MSC-NT-4 actively produced NT-4 in the injured retina and significantly protected damaged retinal cells, as evaluated by ERG and optical coherence tomography (OCT). Of importance, the long-term therapy with MSC-NT-4 was also associated with induction of prosurvival signaling, considerable overexpression of some subsets of transcripts, including several members of the crystallin β-γ superfamily (Cryba4, Crybb3, Cryba2, Crybb1, Crybb2, Cryba1, and Crygc) and significant upregulation of biological processes associated with visual perception, sensory perception of light stimulus, eye development, sensory organ development, and system development. Transplantation of genetically modified MSCs that produce neurotrophic growth factors may represent a useful strategy for treatment of different forms of retinopathies in the future.
Siennicka A.,Pomeranian Medical University
Journal of physiology and pharmacology : an official journal of the Polish Physiological Society | Year: 2013
Many circulating haemostatic markers have been investigated in relation to the abdominal aortic aneurysm (AAA) size, growth as well as intraluminal thrombus (ILT) size. However, the results of these studies seem to be uncertain and inconsistent. The first aim of the present study was to compare the haemostatic parameters of fibrinolysis and some of thrombotic markers in patients with AAA and controls. We also examined the relationship between those parameters and both maximum aneurysm diameter and intraluminal thrombus thickness. Tissue plasminogen activator (t-PA), plasminogen activator inhibitor (PAI-1), fibrinogen (Fb), D-dimer, prothrombin fragments 1 and 2 (F1+2), thromboxane B2 (TXB2) and lipids profile were measured in 36 patients with AAA and 30 controls. The mean maximum aortic diameter in patients with the AAA was 59±12 mm (range 42-100). The mean ILT thickness was 32±10 mm (range 8-56). Among haemostatic factors, t-PA and D-dimer levels, but not PAI-1, were significantly higher in subjects with the AAA. There was a strong positive correlation between thickness of intraluminal thrombus and maximum aneurysm size (r=0.69, p<0.0001), and the negative relationship between t-PA and ILT thickness (r= -0.53, p=0.001) as well as aneurysm diameter (r= -0.38, p=0.023). Higher plasma concentrations of t-PA and D-dimer support the hypothesis that the secondary fibrinolysis plays an important role in the pathogenesis of the aortic abdominal aneurysm formation. In addition, the negative correlation between t-PA plasma level and ILT thickness suggests that thrombotic/fibrinolysis imbalance may favour accelerated formation of intraluminal thrombus and possibly aneurysm progression.
Concentrations of procalcitonin and C-reactive protein, white blood cell count, and the immature-to-total neutrophil ratio in the blood of neonates with nosocomial infections: Gram-negative bacilli vs coagulase-negative staphylococci
Kordekag A.,Pomeranian Medical University
European Journal of Clinical Microbiology and Infectious Diseases | Year: 2011
This study was undertaken to determine whether concentrations of procalcitonin in the blood of neonates with nosocomial infections depend on the type of pathogen. Qualification for the study group was based on the clinical signs of infection. We found that infections with Gram-positive (chiefly coagulase-negative staphylococci) and Gram-negative bacteria are accompanied by elevated concentrations of procalcitonin. In the case of Gram-positive bacteria, other laboratory signs of infection studied by us (concentration of C-reactive protein, white blood cell count, immature-to-total neutrophil ratio) were not discriminatory, confirming the diagnostic usefulness of procalcitonin measurements in nosocomial infections of the neonate with Gram-negative or Gram-positive bacteria. © 2010 The Author(s).