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The aim of this study was to examine the neurophysiological correlates of cognitive dysfunctions in a patient with the minimally verbal variant of Autism Spectrum Disorder (ASD + MV), who after reaching adulthood showed progressive deterioration of his cognitive skills. The patient was a 25-year-old male, diagnosed with ASD. He never developed spoken language, and communicated only by gesturing or writing on a computer. Our findings confirmed comorbidity of ASD and epilepsy, accompanied by dysfunction of cognitive control. We also found that spontaneous EEG and event-related potentials (ERPs) in a cued GO/NOGO task can be used to assess functional brain changes concomitant with ASD.

The use of novel synthetic opioids as recreational drugs has become a public health concern as they are implicated in numerous fatal intoxications across the world. Synthetic opioids have played a major role in the United States opioid crisis and may contribute to a similar opioid epidemic in Europe. The most prominent group of designer opioids consists of fentanyl and its analogues. At present, carfentanil is the most dangerous fentanyl derivative. It was recently detected as an adulterant to other illicit drugs and counterfeit pharmaceuticals, contributing to life-threatening hospital admissions and fatalities. Toxic exposure to carfentanil typically occurs through injection, insufflation or inhalation. Carfentanil produces similar pharmacotoxicological effects to other opioids. However, due to its extraordinary potency, reversing carfentanil-induced severe and recurring respiratory depression requires administration of multiple or higher than standard doses of naloxone. Toxicological reports indicate that carfentanil use is strongly connected to polydrug use. Detection of carfentanil requires specific and sensitive analytical methods that are not commonly available in hospitals. Since abuse of carfentanil is an emerging problem, particularly in the United States, there is an urgent need to develop new techniques for rapid determination of intoxication evoked by this drug as well as new treatment regimens for effective overdose maintenance. This review presents current knowledge on pharmacological activity of carfentanil, prevalence and patterns of use, and analytical methods of its detection. Special emphasis is given to carfentanil-related non-fatal and lethal overdose cases.

BACKGROUND Physiological pregnancy is associated with volume overload. Unlike cardiac pathologies linked with volume overload, such as mitral or aortic regurgitation, pregnancy is thought to be unrelated to fibrosis of the heart. However, changes in the cardiac extracellular matrix during pregnancy remain poorly understood. OBJECTIVES The aim of the study was to examine the expression of 11 microRNAs associated with cardiac fibrosis (miR-21, miR-26a, miR-26b-5p, miR-29b-3p, miR-29c-3p, miR-101a, miR-146a, miR-208a, miR-223 and miR-328) during pregnancy and to compare them with a healthy control group. MATERIAL AND METHODS Six women in singleton pregnancy (30-36 weeks) and 6 non-pregnant women as a control group were included in the study. Each woman underwent an echocardiographic examination, and had blood pressure on both arms measured and a blood sample taken. MicroRNAs expression was analyzed using Custom TaqMan® Array MicroRNA Cards (Applied Biosystems, Foster City, USA). RESULTS Median age of the pregnant women was 34 years (range 25-39 years) and of the control group 32 years (range 29-43 years). Median week of pregnancy was 34 years (range 31-36 years). Most of the examined microRNAs had a lower expression in the pregnancy group (fold change 1.0). CONCLUSIONS In the 3rd trimester of physiological pregnancy, there is a 244% increase in expression of miR-101a and a decrease by 73% in expression of miR-328. Both of these changes can protect against fibrosis during volume overload occurring in physiological pregnancy.

This thesis was written under the assumption that the implementation and adoption of new medical devices can be supported by an early assessment of economic and clinical perspectives. The early stages of the medical device development are found crucial, as early in the lifecycle the device development process can either emerge or conclude without major financial drawbacks for the company. An assessment of medical devices starting at the early stages could result in a decrease of the failure rate at each stage of further medical device development, and thus in an increased Research and Development (R&D) efficiency. This, on the other hand, could lead to more successful reimbursement of new medical innovations and better prioritization of devices that are most likely to succeed.However, as the iterative use of medical device assessment alongside their development is relatively new and unknown, many questions remain. To answer some of those questions, this thesis particularly addressed the:1.clinical need and methods to engage various stakeholders within the medical device development,2.the evaluation of the commercial viability of medical devices early in the lifecycle to prioritize development of the most “beneficial” technologies using potential added value to society and, hence, economic returns,3.the adaptation of a decision support tool for the manufacturers to be used alongside the medical device development process.

Background Infections caused by various microbes may induce immunodeficiency and allergies. Methods Clinical and laboratory tests were conducted on 579 potentially healthy people (172 women and 407 men, between 25 and 30 years), performed twice: in a diagnosis and after 6 to 12 months. Lymphocytes and NK cells from peripheral blood were assessed using cytometry. G, A, M immunoglobulin concentrations were determined by the turbidimetry. IgE concentration was measured by ELFA. HSV2, HIV and Chlamydia trachomatis infections were detected on the basis of presence of IgM and IgG antibodies tested by ELISA. For the assessment of HPV infections, DNA from the urinary-tract, squamous, and epithelial cells was tested through PCR. The statistical analysis was undertaken using regression analyses. Results In 579 people in the case of 65 people HPV infections were confirmed 10% men, 14.8% women. In 65 patients, in 1 case concentration of IgA was decreased, in 7 cases IgM. In 21 cases, there were higher concentrations of IgE. During the cytometric analyses a decreased number of T CD3+ was found in 3 cases, BCD19+ in 5, TCD4+ in 5, T CD8+ in 4, and NK cells in 8 cases. The check for HSV2 was positive for 17 people: 1.5% men, 6.4% women. In this group in 3 cases the concentration of IgA was decreased; in 2 cases IgM was lowered, in 4 cases there were higher concentrations of IgE. Decreased number of lymphocytes CD19+ was observed for 1 person and for 1 person NK cells. Chlamydia trachomatis infections were positive in 10 cases: 1.5% men, 2.3% women; in this group 1 person had lower IgA and 2 persons had increased concentrations of IgE. HIV infection was negative for all the groups. The examination was repeated for 171 out of 579 people after 6 months. HPV infections were positive in 12.9% cases: 14.9% men, 10.8% women; HSV2 in 11 persons: 2.3% men, 10.7% women; Chlamydia trachomatis in 4 cases: 2.3% men 2.4% women. Conclusions No significant correlation was observed between HPV, HSV2, HIV and Chlamydia trachomatis infections and a relevant deviation from the norm of the investigated immunological parameters.

Results Lower number of lymphocytes population in children with osteosarcoma compared to the control group was observed. The differences concerned lymphocytes CD3+ (1609,0 vs 3038,0 kom/μl, p

Background The type I or IV of hypersensitivity reactions according to Gell and Coombs classification may be responsible for clinical symptoms observed after ingestion of gluten - containing products. The mechanisms of these reactions are either IgE-dependent or IgE-independent. Celiac disease based on IgE-independent mechanism is classified as gluten hypersensitivity. Clinical manifestation of celiac disease and gluten allergy is often similar. Correct diagnosis of this disease is particularly important due to the different long-term therapeutic procedures. We would like to asses of the incidence of celiac disease in children with gluten allergy. Methods The study involved 50 children with abdominal pain, chronic diarrhea, recurrent respiratory and ears inflammation and skin lesions - patients of the Immunological and Gastroenterology Outpatient Clinic of Institute of Mother and Child. The allergy to gluten was confirmed on the basis of positive peripheral blood lymphocytes blast transformation test and detection of allergen-specific IgE antibodies to gluten (f79). In all children plasma concentration of immunoglobulin classes A, G M and IgA or IgG antibodies against tissue transglutaminase (tTGA) were measured. Results In children on the study group the type IV of hypersensitivity reaction to gluten was diagnosed. In 3 children specific IgE antibodies to gluten was also confirmed (f79 - I type hypersensitivity). Anti-tissue transglutaminase antibodies both IgA and IgG were detected in 2 children in whom the concentration of IgA and IgG in serum remained within normal range for age. In these children celiac disease was confirmed by jejunal biopsy. Conclusions The predominant frequency of type IV of hypersensitivity reactions in children in response to the gluten antigen should be taken into account in diagnosis of food allergy. In children diagnosed with gluten allergy the test for celiac disease should be performed.

Background Infections caused by various microbes may induce immunodeficiency and allergies. Methods Tests were conducted on 579 potentially healthy people (172 women and 407 men, between 25 and 30 years), performed twice: in a diagnosis and after 6 to 12 months. Lymphocytes and NK cells from peripheral blood were assessed using cytometry. G, A, M immunoglobulin concentrations were determined by the turbidimetry. IgE concentration was measured by ELFA. HSV2, HIV and Chlamydia trachomatis infections were detected on the basis of presence of IgM and IgG antibodies tested by ELISA. For the assessment of HPV infections, DNA from the urinary-tract, squamous, epithelial cells were tested through PCR. The statistical analysis was undertaken using regression analyses. Results In 579 people in the case of 65 people HPV infections were confirmed 10% men, 14.8% women. In 65 patients, in 1 case concentration of IgA was decreased, in 7 cases IgM. In 21 cases, there was higher concentration of IgE. During the cytometric analyses a decreased number of T CD3+ was found in 3 cases, BCD19+ in 5, TCD4+ in 5, T CD8+ in 4, and NK cells in 8 cases. The check for HSV2 was positive for 17 people: 1.5% men, 6.4% women. In this group, in 3 cases the concentration of IgA was decreased, in 2 cases IgM was lowered, in 4 cases there were higher concentrations of IgE. Decreased number of lymphocytes CD19+ was observed for 1 person and for 1 person NK cells. Chlamydia trachomatis infections were positive in 10 cases: 1.5% men, 2.3% women, in this group 1 person had lower IgA and 2 persons had increased concentrations of IgE. HIV infection was negative for all the groups. The examination was repeated for 171 out of 579 people after 6 months. HPV infections were positive in 12.9% cases: 14.9% men, 10.8% women; HSV2 in 11 persons: 2.3% men, 10.7% women; Chlamydia trachomatis in 4 cases: 2.3% men 2.4% women. Conclusions No significant correlation was observed between HPV, HSV2, HIV and Chlamydia trachomatis infections and a relevant deviation from the norm of the investigated immunological parameters.

Background Poor different acceptance of milk-free formulas in the diet of children with allergy to cows’ milk (CMA) poses the risk of nutritional deficiencies especially calcium, vitamin D and iron and also can lead to malnutrition. Methods Sixty children aged 2-5 years were divided into two groups: group I - 40 children with CMA, group II –20 healthy controls. In children diagnosed with allergy to cow’s milk, milk free diet was recommended. Dietary intake and nutritional status were assessed at six-monthly intervals: at the beginning of the study and after 6 and 12 months of observation. Nutritional status of children was assessed with anthropometric traits and indices (i.e. Body Mass Index) and selected biochemical parameters were performed. Results Despite of differences in the average concentration in the serum of children with both groups of proteins, albumin and iron, their values ranged of standards for age, as well as the assessed value of other biochemical parameters. At the beginning of the study BMI z-score of 75% of children in group I and 80% in group II ranged between -1,0 to +1,0 whereas BMI z-score in 25% of group I and 20% of group II between -2,0 and -1,0. After 12 month follow–up in 91,5 % of children of group I and 88% of group II BMI z-score was between -1,0 to +1,0 while in 8,5% of children in group I and 12% in group II between -2,0 to -1,0. Conclusions Nutritional status of children with CMA assessed by body mass index, and selected biochemical tests was normal. In children during 12 month of period of the study, positive changes in dietary habits were observed. Children with CMA should remain under pediatric and dietician care in order to monitor their nutritional status and diet. Nutrition care is also indicated for children on a traditional diet.