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Lacka K.,University Medyczny Im rcinkowskiego znaniu | Maciejewski A.,Poznan University of Medical Sciences
Polski Merkuriusz Lekarski | Year: 2012

Autoimmune thyroiditis (Hashimoto's disease) is a polygenic disorder with complex etiopathogenesis. Apoptosis is proposed as one of its mechanisms. Programmed cell death is essential for the maintenance of homeostasis, but when it is deregulated, it may contribute to the development of disorders. There are two apoptotic pathways: intrinsic and extrinsic. The extrinsic pathway may be activated among others through FasL binding to its receptor Fas. The FasL induced apoptotic pathway proceeds with cascade activation of following caspases, with final effector proteins recruitment. There is also a group of inhibitory proteins of apoptosis, where the Bcl-2 protein predominates. In the course of Hashimoto's disease the following aberrations are encountered: increased Fas/FasL expression, caspases and Bid protein concentrations, decreased Bcl-2 concentration and at the same time increase of Bcl-2 within intrathyroidal lymphocytes. They favor the thyrocytes apoptosis and thyroid gland destruction. Synergistically acting proapoptotic cytokines IFN-y and TNF or IL-β, are considered to be major factors of the abnormalities mentioned above. TSH, T 3 and T 4, TSAb and TSBAb antibodies and iodide concentration may also play a role in pro-and antiapoptotic factors expression regulation. The role of TRAIL protein in the course of Hashimoto's thyroiditis needs evaluation. The current data on the role of apoptosis in the etiopathogenesis of the autoimmune thyroiditis will be presented and discussed.

World Health Organization includes the eight main risk factors, which causes about 61% of cardiovascular deaths. These factors are: tobacco and alcohol use, high blood pressure, high body mass index, abnormal blood lipid levels, high blood glucose, a diet high in saturated fat and low in fruit and vegetable intake and physical inactivity. Thanks to them it's possible to expect probability of illness and its complication. Particularly exposed to cardiovascular morbidity are those patients who have multiple risk factors. The investigated group consisted of 114 male patients, who lived in Poznan. The authors analyzed lifestyle factors (smoking, prophylactic examination, exercise and leisure activities and diet), which were compared with laboratory and diagnostic tests plus selected individual characteristics of respondents. Answers distribution within the group are presented as percentages. The aim of the study was to analyze health behaviors among men age > 50 years related to risk factors cardiovascular diseases. Results shows that most of the study group had overweight or obesity and their daily physical activity was confined only to the work in the garden or walking. There were 33% of men with BMI>30, which increases their risk of heart attack twice. Incidence of hypertension was related to obesity, high blood cholesterol and high triglyceride levels. Vascular interventions occurs more frequently among daily smokers and former smokers. More than half of study group with hypertension stopped smoking because of their diseases. Men who declared healthy lifestyle more frequently perform prophylactic control tests and examination. Mostly three or four risk factors were found among study group. For the men after 50 there should be implemented more prophylactic programs, to encourage lifestyle changes and eliminate risk factors.

Osmalek T.,University Medyczny Im rcinkowskiego znaniu
Przegla̧d lekarski | Year: 2012

Photodynamic therapy (PDT) is used mainly in tumor diagnosis and treatment. It is obvious that PDT can increase the efficiency of traditional methods such as surgery, chemotherapy or radiotherapy. Unfortunately, photosensitizers used in the treatment are still imperfect. According to severe side effects, patients need to change their life habits even for several weeks. The problem is attributed to insufficient selectivity of dyes toward cancer tissues. Safety of PDT can be improved by application of various carriers including liposomes, nanotubes or nanoparticles. Binding of photosensitizers to tumor specific molecules opens broad new possibilities for PDT.

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.

The expression of the most important chaperone protein - Hsp70 and autoimmunity directed against it is a risk factor of cardiovascular diseases, increased in subjects with alcohol use disorder (AUD). The aim of the study was to evaluate the level of anti-Hsp 70 protein antibodies (anti-Hsp 70) in sera of AUD patients during abstinence period. Material and methods. The study included 54 subjects with AUD diagnosed basing on DSM IV criteria. In the studied group clinimetric evaluation was performed, plasma lipids, basic transketolase activity in erythrocytes (TK), thiamine pyrophosphate (TPP) activation of transketolase and the level of anti-Hsp 70 antibodies were evaluated as well. Results. In AUD subjects anti-Hsp 70 level was decreased during abstinence period. During first month of abstinency it correlated negatively with total cholesterol concentration (rS=-0.8857, p=0.0188) and the percentage of TPP stimulation (rS=-0.5960, p<0.05), and during 6 months of abstinence with HDL cholesterol (rS=-0.6848, p=0.0289). After 1 year of abstinence anti-Hsp 70 correlated positively with basic TK activity (rS=0.9550, p=0.0008). Sex is an independent factor influencing anti-Hsp 70 level in AUD subjects (B=60.9469, p=0.0435). In multiple regression model including results of clinimetric evaluation and its effect on the level of anti-Hsp 70 antibodies in AUD patients during 1 month of abstinency anti-Hsp 70 correlated with TWEAK scale score (BETA=-1.4543, p=0.0144) and AUDIT score (BETA-=1.2255, p=0.0224). In 2-6 months of abstinency anti-Hsp 70 correlated with TWEAK score (BETA=1.1110, p=0.0418). After 1 year of abstinency anti-Hsp 70 correlated with AUDIT score (BETA=-1.2161, p=0.0210). Conclusion. The autoimmune reaction against Hsp 70 is decreased during abstinency in AUD patients. Its relation with plasma lipids and thiamine deficiency may lead to increased risk of cardiovascular disorders. TWEAK and AUDIT scoring seem to be most useful for clinimetric evaluation in the context of the role of anti-Hsp 70 antibodies.

The cellular vaults have been described for the first time in 1986 as ribonucleoprotein complexes composed of three proteins, MVP, TEP1 and vPARP and several vRNA strains. Biochemical and structural studies revealed their ubiquitous existence in the cytoplasm of many eukaryotic cells and their barrel-like structure indicating their engagement in the intracellular transport. Furthermore, the high homology between MVP and LRP which was already known to be involved in multidrug resistance mechanism opened a discussion about the role of vaults in both normal and cancer cells. The histopathology research demonstrated an increased amount of MVP/LRP proteins in the cancer as well as showed translocation possibility between cytoplasm and nuclear envelope, which can be of crucial point in the prevention of nucleus against anticancer drugs.

Breborowicz A.,University Medyczny Im rcinkowskiego znaniu
Polski Merkuriusz Lekarski | Year: 2011

Antibiotics have significant role in the treatment of respiratory diseases. The main aim of their use is to treat infection, but anti-inflammatory properties of macrolides are also beneficial in selected diseases. The role of antibiotics in the therapy of asthma exacerbation can be neglected and should be limited to exceptional situations of bacterial infections which are very rare. During last few years the role of atypical infections in asthma inception, induction of exacerbation and modification of chronic course of disease has been discussed. Antibiotics play significant role in cystic fibrosis therapy. They are especially recommended during exacerbation, when new pathogens are revealed and in chronic Pseudomonas aeruginosa infection. This paper includes the principal rules of antibiotics therapy in patients with cystic fibrosis. The role of azithromycin in antiinflammatory therapy in this group of patients is also presented.

Cyanides are relatively rare cause of acute poisonings. The majority of data on toxic effects of cyanide compounds on the human body, come from the experiences gained from accidental poisonings in the workplace, with fire smokes or during chemical incidents. However, from immemorial time, cyanides were also used in suicide attempts. The aim of this paper is to present the case of suicidal cyanide poisoning of 26-year-old woman, who was admitted to the toxicology department one hour after ingestion of unknown cyanogenic compound, probably bought on the Internet. Despite intensive symptomatic treatment and antidote administration (hydroxocobalamine), patient died after 78 hours of treatment.

Ethylene glycol (EG) is a multidirectional, dihydric alcohol, which is widely used in food, chemical and automotive industries. EG is a compound of similar toxicity to ethanol (EA). The EG biotransformation undergoes, mainly to glycolaldehyde and acids: glycolic, glyoxylic and oxalic acid, such metabolites, which exhibit strong narcotic effect on the central nervous system, causing profound metabolic acidosis and lead to severe nephropathy. Due to the wide availability of products containing ethylene glycol and its potential toxicity, in the case of the alcohol poisoning, the significant role in the diagnosis play: medical interview, observation of characteristic clinical symptoms, basic laboratory tests and detection of ethylene glycol in the biological material that confirm EG poisoning.

Primary adrenocortical insufficiency (Addison's disease) requires lifelong steroid substitution. Although the patients are both at risk of under-replacement and excessive glucocorticoid exposure, there is no consensus on monitoring this therapy. The aim of the study was to assess the substitution therapy in Addison's disease in regard to metabolic balance, glycaemic effects and bone mineral density. Seventy two subjects with primary adrenal insufficiency (52 women, 20 men) were evaluated. Mean disease duration was 15.6 years. All patients were supplemented with hydrocortisone (10-60 mg/day), 45 also used fludrocortisone, and 8 - dehydroepiandrosterone. The patients underwent medical examination, assessment of glycaemia and electrolyte parameters, and hormonal analyses. Bone mineral density was evaluated in 65 individuals. Mean blood pressure in patients was 117/74 mmHg and positively correlated with age (p < 0.001). No correlation was found between the daily hydrocortisone dose and blood pressure nor electrolyte parameters. Mean morning serum cortisol before hydrocortisone administration was 27 +/- 42 nmol/l, 2 hours later 904 +/- 263 nmol/l, 222 +/- 226 nmol/l before the afternoon dose, and 219 +/- 192 nmol/l around 22.00. Mean 24h urinary cortisol excretion was 521.5 +/- 387 nmol, and morning plasma ACTH was 398.9 +/- 423 pg/ml. Fasting serum glucose was 83.6 +/- 12.6 mg/dl. Fasting glycaemia and insulinaemia did not correlate with hydrocortisone dose but did present a positive correlation with body mass and age. Sixteen patients were diagnosed with osteoporosis in the lumbar spine, and 6 women--in femoral neck. Bone mineral density correlated positively with serum DHEA-S, and negatively with the patient's age, duration of the Addison's disease and total steroid dose administered during the therapy. In conclusion, the steroid substitution in Addison's disease requires individually tailored dosage and adequate monitoring. The factors which may potentially contribute to the development of adverse effects of the glucocorticoid over-supplementation are age, duration of the Addison's disease and total administered steroid dose.

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