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Addison-Biermer's anaemia is an autoimmune disease and the most common cause of vitamin B12 deficiency. Hashimoto disease is the most common type of the thyroiditis and also has autoimmunological origin. Frequent coexistence of both mentioned entities has been observed. In the paper we report a case of a woman, who was diagnosed with pernicious anaemia (PA) with predominant neurological symptoms and concomitant autoimmune thyroiditis. Many efforts have been made in order to explain frequent coexistence of mentioned diseases. Both genetic (mainly HLA region genes) and environmental (mostly bacterial infections) factors are considered. The aim of the study was to emphasize significance of diagnosing thyroid gland diseases among PA patients. It is also important to remember that neurological symptoms are frequent in the course of PA and may precede other complaints. However it should not prevent the right diagnosis.


Rybakowski J.,University Medyczny Im rcinkowskiego | Dmitrzak-Weglarz M.,University Medyczny Im rcinkowskiego znaniu | Dembinska-Krajewska D.,University Medyczny Im rcinkowskiego | Hauser J.,University Medyczny Im rcinkowskiego znaniu
Neuropsychiatria i Neuropsychologia | Year: 2013

Aim of the study: This study assesses an association between functional polymorphisms of the brain-derived neurotrophic factor ( BDNF) gene, catechol-O-methyltransferase ( COMT ) gene and serotonin transporter gene and personality dimensions measured by the Temperament Scale of Memphis, Pisa, Paris and San Diego - Autoquestionnaire (TEMPS-A) and the Oxford-Liverpool Inventory of Feelings and Experiences (O-LIFE) in patients with bipolar affective illness. Material and methods: The study was performed on 70 patients with bipolar affective illness (21 men, 49 women) aged 59 ±12 years, from the outpatient clinic, Department of Adult Psychiatry, Poznan University of Medical Sciences. The TEMPS-A was applied, measuring depressive, hyperthymic, cyclothymic, irritable and anxious temperament as well as the O-LIFE, measuring schizotypy dimensions: unusual experiences, cognitive disorganization, introversion and anhedonia and impulsive nonconformity. Genotyping of Val66Met polymorphism of the BDNF gene, Val108Met polymorphism of the COMT gene and 5-HTLPR s/l polymorphism of the serotonin transporter gene was performed. Results: Carriers of the Met allele of Val66Met BDNF gene polymorphism showed significantly higher irritability dimension on TEMPS-A. Among carriers of the Met allele of Val108Met COMT gene polymorphism, significantly higher cognitive disorganization and introvertive anhedonia on O-LIFE were observed. Finally, patients with s/s genotype of 5-HTLPR polymorphism had a higher cyclothymia dimension at the level of a statistical trend (p = 0.06). Conclusions: The association between BDNF gene polymorphism and irritability in the TEMPS-A has not been previously reported. A connection between the COMT gene and features of schizotypy as well as between the serotonin transporter gene and cyclothymia is discussed in the context of results of other researchers.


Opara J.,Katedra Fizjoterapii Ukladu Nerwowego i Narzadu Ruchu | Jaracz K.,University Medyczny Im rcinkowskiego | Brola W.,Oddzial Neurologiczny
Neurologia i Neurochirurgia Polska | Year: 2012

Multiple sclerosis (MS) is the second most common cause of disability among nervous system diseases. This disease causes reduced quality of life of patients and those caring for them. Quality of life (QoL) measures consist of at least three broad domains: physical, mental and social. In the field of medicine, researchers have often used the concept of health-related quality of life, which specifically focuses on the impact of an illness and/or treatment on patients' perception of their status of health and on subjective well-being or satisfaction with life. Subjective factors of QoL in MS patients include perception of symptoms, level of fitness, self-image, satisfaction with family life, work, the economic situation, interaction with other people, social support and life in general. Objective factors include the clinical picture of disease, social status, social and living conditions and the number and intensity of social contacts. While many generic and specific questionnaires have been developed to assess QoL in patients with MS, including general fatigue, there is a lack of specific questionnaires assessing QoL of caregivers. In this paper, a review of selected studies on QoL and caregiver burden in MS and a summary of the most popular questionnaires measuring burden and QoL are presented. Special attention is paid to the first questionnaire specific for QoL of carers of persons with MS, CAREQOL-MS by Benito-León et al.


Towpik I.,Szpital Wojewodzki SPZOZ w Zielonej Gorze | Wender-Ozegowska E.,University Medyczny Im rcinkowskiego
Ginekologia Polska | Year: 2014

The aim of the paper was to present data that enable us to determine whether treatment of hyperglycemia diagnosed during pregnancy, in the era of a steadily growing number of women with gestational diabetes mellitus (GDM) and an ongoing debate about new criteria and diagnostic strategies, is a valid option. GDM is the main metabolic disorder developing during pregnancy, complicating around 6% of all pregnancies. Mistreatment of hyperglycemia during pregnancy may cause several fetal complications, especially neonatal overgrowth (macrosomia or LGA). The risk of macrosomia is directly related to maternal hyperglycemia (twice as high as in the control group with glucose levels exceeding 130 mg/dl). Apart from maternal hyperglycemia and fetal hyperinsulinemia, insulin-like growth factors and selected adipocytokines produced by adipose tissue and placenta are among the factors contributing to the development of diabetic fetopathy, whose risk increases by 2-fold with glucose levels exceeding 130 mg/dl. The role of hyperglycemia as a factor inducing several perinatal complications was confirmed by the HAPO study, but it is not the sole reason of adverse effects. Also, maternal obesity, weight gain during pregnancy and maternal hyperlipidemia seem to be involved in the pathogenesis of feto-maternal complications. Changes in fetal growth, disturbances in the perinatal period, there just some of the negative consequences of maternal GDM. Disturbance of carbohydrate metabolism during pregnancy causes long-lasting consequences for both, the mother and the child, including increased risk of overt diabetes, metabolic syndrome and cardiovascular complications. Children born to GDM mothers are at a significant risk of psycho-motoric disability and a higher risk of schizophrenia. ACHOIS and MFMU studies have confirmed that even mild hyperglycemia, detected and treated in a timely manner, significantly improves maternal and fetal outcome. Various meta-analyses have revealed a positive effect of GDM treatment. To the best of our knowledge, no clinical study has revealed negative effects of such treatment, with the exception of an increased number of perinatal visits. © Polskie Towarzystwo Ginekologiczne.


Klukowska A.,Katedra i Klinika Pediatrii | Zawilska K.,University Medyczny Im rcinkowskiego
Acta Haematologica Polonica | Year: 2015

The treatment of patients with haemophilia A and B is based on substitution of factor VIII and factor IX. The half-life of factor VIII (about 11 hours) and factor IX (about 18 hours) are rather short, so frequency of prophylactic infusions of factor VIII and factor IX concentrates are not less than 3 or 2 times a week. The development of new factor VIII and factor IX concentrates with longer half-lives makes possible the prolongation of time between doses and the improvement of prophylaxis efficacy. The fusion of factor IX to polyethylene glycol, Fc fragment of immunoglobulin G or albumin prolonged half-life of this coagulation protein to almost 100 hours. The half-life of factor VIII concentrate, with recombinant factor VIII combined with polyethylene glycol or Fc fragment of immunoglobulin G is prolonged to about 19 hours. Modification of factor VIII structure to produce single-chain protein with increased binding to von Willebrand factor is a new promising project as well. The introduction of coagulation concentrates with prolonged half-life will improve the quality of life of patients with severe type of haemophilia. © 2015 Polskie Towarzystwo Hematologów i Transfuzjologów, Instytut Hematologii i Transfuzjologii.


Examination of visual evoked potentials (VEP) enables objective, non-invasive diagnostics of vision damage in children and adolescents. It is important to choose proper stimulus for individual patient. The aim of this research was analysis of VEP variability and disclosure of possible differences recorded in healthy children and adolescents while binocular recording, using four various types of stimulus. VEPs with pattern reversal (PR 15 and 40 min arc), flashing screen and light emitting diodes (LEDs) in goggles were measured in 100 children and adolescents 1-18 year according to International Federation of Clinical Neurophysiology recommendations. Normative data for VEP's parameters and hemispheric differences under these kinds of simulations were reported. Influence of used stimulation on value of only VEP component latency was confirmed. Application of PR brings longer latencies than with use of flash methods. Changes of VEP parameters connected with maturation of visual pathway in children up to age of 8 were demonstrated. The constant value of responses registered from above left and right cerebral hemispheres was observed which indicates symmetry of recording obtained. Variability of VEP recording character depends on application of various stimulus parameters and various methods of their presentations. Consequently, every laboratory performing potential examinations should establish parameter pattern of VEP with strictly defined standardized conditions of stimulation and recording.


Kalinowska-Lyszczarz A.,University Medyczny Im rcinkowskiego
Neuropsychiatria i Neuropsychologia | Year: 2012

Neurotrophins regulate neuronal survival and differentiation, and facilitate synaptic plasticity in the central nervous system (CNS). Although neurons are the major source of neurotrophic factors, they are also expressed within the peripheral blood mononuclear cell (PBMC) fraction of the immunological system. Multiple sclerosis (MS) is a chronic inflammatory demyelinating and neurodegenerative disease of the central nervous system (CNS), causing cognitive impairment in approximately half of the patients. In MS additional neurotrophic support from PBMCs might compensate the relative neurotrophin deficiency in the damaged CNS tissue that needs to be repaired. Neurotrophins, namely nerve growth factor (NGF), brainderived neurotrophic factor (BDNF), neurotrophin-3 (NT-3) and neurotrophin-4/5 (NT-4/5), may exert a potentially neuroprotective role in MS-damaged CNS, in fluencing the structural brain atrophy rate and functional connectivity, with both these aspects contributing to cognitive performance in MS patients. So far a lot of evidence has been gathered based on animal model studies, and evidence from studying human disease is gradually emerging. The association between neurotrophins and the CNS cholinergic system has been underlined; however, the exact mechanism of neurotrophin-mediated neuroprotection is not yet fully understood. Neurotrophins have been considered as potential novel therapies for neurodegenerative diseases, especially those with cognitive involvement. The aim of this review is to present the role of neurotrophins in the context of MS-related cognitive impairment.


The aim of the study was to asses the influence of tobacco smoking on plasma oxidative stress parameters in normal glucose tolerance persons and pre-diabetic individuals, separately. Caucasian females and males aged 35-64, with no acute or severe chronic disorder, taking no medication, special diet nor supplementation were enrolled to the study. After receiving oral glucose tolerance test results, newly diagnosed type 2 diabetic subjects were excluded, and normal glucose tolerance (NGT) and pre-diabetic (PreDM) persons underwent further investigation. Both groups were divided due to their positive (P) or negative (N) history of smoking. The studied subjects were determined in plasma: lipid parameters (T-C, HDL-C, TG, LDL-C), total antioxidant status, TAS (Randox, Statfax 1904 Plus) and thiobarbituric acid-reactive substances, TBARS (Sigma, UV-160A Shimadzu) as lipid peroxidation products. They were also measured serum insulin concentration (ELISA-BioSource, Sunrise Tecan) and insulin resistance indices IR = Ins/G0'[mg/ dl] and HOMA-IR = {G0'[mmol/l]*Ins}/ 22.5 were calculated. Statistical analysis was performed using Statistica 6.0 program for following groups: NGT-N (n = 25: 15 F, 10 M), NGT-P (n = 21: 10 F, 11 M), PreDM-N (n = 23: 13 F, 10 M) and PreDM-P (n = 21: 7 F, 14 M). 1. NGT-P group comparing with NGT-N group presented higher concentration of fasting glucose, T-C, LDL-C, and TBARS (8.43 +/- 5.24 vs 4.81 +/- 2.58 nmol/ l). PreDM-P individuals, as compared with PreDM-N, were found decreased TAS (1.20 +/- 0.16 vs 1.42 +/- 0.19 mmol/l) and increased TBARS (10.87 +/- 6.79 vs 6.67 +/- 4.90 nmol/l), negatively correlated TAS & TBARS (R = -0.87; p = 0.0000). 2. The comparison among groups NGT-N, NGT-P, PreDM-N, PreDM-P (using Kruskal-Wallis ANOVA test) revealed marked increase of TAS in PreDM-N subjects and higher TBARS concentration in smokers (both NGT-P and PreDM-P). Systematical regress in plasma HDL-C and progress in TG concentrations were observed from NGT-N through NGT-P and PreDM-N to PreDM-P. In case of increased risk for type 2 diabetes, we suggest an effective mobilization of plasma antioxidant status preventing high concentration of lipid peroxidation products, in nonsmokers only.


Barczak W.,University Medyczny Im rcinkowskiego | Rubis B.,University Medyczny Im rcinkowskiego
Nowotwory | Year: 2012

Cancer cells are characterized by an increased telomerase activity. The enzyme is responsible for reconstruction of telomeres. Telomeres, as specialized nucleoproteins that are located at the end of chromosomes, provide genome stability and integrity. The most important consequence of their restore in cancer cells is their immortality. The studies carried out within last few years on telomerase and telomere length indicate that their regulation is controlled by factors released during carcinogenesis i.e. hormones and cytokines. Consequently, those factors also modulate telomerase also in normal cells. This causes changes in the human organism even at the local area (cancer initiation at a single cell level) which may be reflected by alterations in whole organism (including leukocytes). The latest studies point to some differences in the measured telomere length in leukocytes between adenocarcinoma patients and control subjects. Considering the results of previous studies it seems justified to adopt the thesis that telomere length (or telomerase activity) in leukocytes can be evaluated as a marker of tumor occurring at a very early stage of carcinogenesis. Thus, it seems that telomere length measurement in leukocytes, as a low-invasive method, might be a good method for predictive assessment of carcinogenesis. In this work we focused on potential application of telomere length analysis as a pro-gnostic parameter at the early stage of cancer development in breast and lung cancer. We also report on numerous methods of telomere length analysis showing their strengths and weaknesses. © Polskie Towarzystwo Onkologiczne.


The aim of the study was to compare obstetric results in two groups of pregnant women (patients that had and had not planned their pregnancy) suffering from pregestational diabetes mellitus (PGDM). 400 women with PGDM were divided into two subgroups: planned pregnancy (P) (N = 200) and unplanned pregnancy (NP) (N = 200). The study was based on retrospective analysis of data collected at the Department of Obstetrics and Women Diseases, University of Medical Sciences, Poznan, from patients who delivered between 1995-2006. In both groups obstetrical complications and selected neonatal parameters were analyzed. Statistically important differences in obstetric results between the two analyzed subgroups of patients were observed P-group was metabolically better controlled, both upon admission to our department and in the third trimester The mean daily insulin requirement among P-group patients was smaller than among pregnant NP-women upon admission to our department. P-patients suffered from miscarriages and stillbirths less frequently Neonates born to P-mothers had higher gestational age at delivery and their Apgar score and cord blood results were significantly better Our results confirmed that patients with PGDM who plan their pregnancies achieve significantly better obstetric results compared with unplanned pregnancy group. Pregnancy planning should become a standard of obstetric and diabetic care in this group of patients.

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