Search

Introduction: Despite considerable progress in knowledge, ischaemic stroke is still a disease that causes serious clinical problems. A role in its pathogenesis can be attributed to i.a. adipose tissue hormones. The aim of this paper is to assess the blood levels of selected adipocytokines in patients during the acute phase of ischaemic stroke as compared to healthy persons, and an attempt to indicate a correlation between their blood concentrations and the level of stroke severity and its outcomes. Material and methods: The study included 46 patients with fresh ischaemic stroke (27 females, 19 males, average age 67.6 years). All patients had a CT scan of the head, their neurological condition was assessed using a stroke severity scale, and their blood levels of resistin, chemerin, and visfatin were tested. The control group consisted of 32 patients (16 females, 16 males, average age 64.1 years) who had never suffered cerebrovascular diseases. Results: Elevated levels of both resistin and chemerin were found in the group of patients with ischaemic stroke (9.17 ± 2.95 ng/mL vs. 6.55 ± 2.01 ng/mL for resistin and 265.0 ± 59.3 ng/mL vs. 191.0 ± 43.6 ng/mL for chemerin). It was also found that the blood concentration of chemerin was higher in females than in males with stroke. However, no difference was found in visfatin blood concentration between the group with ischaemic stroke and the control group (1.65 ± 1.09 ng/mL vs. 1.5 ± 1.39 ng/mL). Conclusions: Higher resistin and chemerin blood concentrations significantly increase the risk of ischaemic stroke. The level of stroke severity at the moment of its occurrence and during its course do not depend on the concentrations of adipocytokines under analysis.

The study was designed to evaluate the effect of thyroid function on serum levels of different adipokines in obesity. We investigated relationships between the thyroid axis and serum levels of leptin, adiponectin, and chemerin, and we assessed the influence of autoimmune thyroiditis (AIT) on those relations.The participants of this study included 181 euthyroid patients (147 women and 34 men) with obesity [body mass index (BMI) 30-39.9 kg/m²] and severe (morbid) obesity (BMI ≥ 40 kg/m²), aged 18 to 65 years. We divided all obese patients by thyrotropic hormone (TSH) tertiles, and we compared all participants according to BMI. Patients were further divided into the following subgroups: with chronic autoimmune thyroiditis and without autoimmune thyroiditis.Comparison of obese patients according to TSH tertile showed significantly higher serum concentrations of leptin, chemerin, and thyroid antibodies and an increased leptin/adiponectin ratio in the group with high normal TSH. We observed statistically significant correlations between serum TSH and BMI, leptin, chemerin, thyroid peroxidase antibodies, and the leptin/adiponectin ratio. In patients diagnosed with autoimmune thyroiditis, higher levels of antibodies and TSH were found, but there were no differences in homeostatic model assessment index (HOMA-I), the leptin/adiponectin ratio, and adipokine levels. In obese patients the relationships between serum leptin, chemerin, the leptin/adiponectin ratio, and BMI were dependent on each other.Serum leptin, chemerin, the leptin/adiponectin ratio, and BMI are significantly higher in patients with high normal TSH; however, selected adipokines are not related to the presence of autoimmune thyroiditis. There are interplays between TSH, adipokines, and obesity, but how these relationships are related remains unknown.

Introduction: Osteoporosis and obesity are considered civilisation diseases. Menopause is a time of increased bone resorption and increased mass of adipose tissue. Adipocytokines secreted by the adipose tissue are believed to be a potential factor in the pathogenesis of osteoporosis. Material and methods: The aim of this research was to assess leptin, adiponectin, and resistin secretion in obese postmenopausal women with osteoporosis and determine whether obesity might be a factor mitigating the risk of osteoporosis. The study involved 80 postmenopausal women with osteoporosis divided into groups: I with BMI of 30.0 34.9, obese; and II with BMI of 18–24.9, normoweight. Leptin, adiponectin and resistin concentrations were assessed, and bone mineral density (BMD) was measured in the L1-L4 section of the spine using the DXA densitometric method. Results: The results of the comparison of the two groups indicate a statistically significant dependence in groups regarding leptin secretion; the group of obese women demonstrated significantly higher concentrations. No differences between the groups were demonstrated for adiponectin or resistin secretion. Conclusions: Higher leptin concentration and a positive correlation with BMI was confirmed in obese postmenopausal women with osteoporosis. It was also demonstrated that BMD increases with growing BMI. No effect of obesity on the secretion of adiponectin or resistin in women with postmenopausal osteoporosis was found. From among the investigated adipocytokines, only leptin can be considered a bone tissue protective factor in postmenopausal women.

The SARS-CoV-2 infection [coronavirus disease 2019 (COVID-19)] is associated with severe lymphopenia and impaired immune response, including expansion of myeloid cells with regulatory functions, e.g., so-called low-density neutrophils, containing granulocytic myeloid-derived suppressor cells (LDNs/PMN-MDSCs). These cells have been described in both infections and cancer and are known for their immunosuppressive activity. In the case of COVID-19, long-term complications have been frequently observed (long-COVID). In this context, we aimed to investigate the immune response of COVID-19 convalescents after a mild or asymptomatic course of disease. We enrolled 13 convalescents who underwent a mild or asymptomatic infection with SARS-CoV-2, confirmed by a positive result of the PCR test, and 13 healthy donors without SARS-CoV-2 infection in the past. Whole blood was used for T-cell subpopulation and LDNs/PMN-MDSCs analysis. LDNs/PMN-MDSCs and normal density neutrophils (NDNs) were sorted out by FACS and used for T-cell proliferation assay with autologous T cells activated with anti-CD3 mAb. Serum samples were used for the detection of anti-SARS-CoV-2 neutralizing IgG and GM-CSF concentration. Our results showed that in convalescents, even 3 months after infection, an elevated level of LDNs/PMN-MDSCs is still maintained in the blood, which correlates negatively with the level of CD8+ and double-negative T cells. Moreover, LDNs/PMN-MDSCs and NDNs showed a tendency for affecting the production of anti-SARS-CoV-2 S1 neutralizing antibodies. Surprisingly, our data showed that in addition to LDNs/PMN-MDSCs, NDNs from convalescents also inhibit proliferation of autologous T cells. Additionally, in the convalescent sera, we detected significantly higher concentrations of GM-CSF, indicating the role of emergency granulopoiesis. We conclude that in mild or asymptomatic COVID-19 convalescents, the neutrophil dysfunction, including propagation of PD-L1-positive LDNs/PMN-MDSCs and NDNs, is responsible for long-term endotype of immunosuppression.

Background Pirfenidone is an antifibrotic agent approved for the treatment of idiopathic pulmonary fibrosis (IPF). The drug is available for Polish patients with IPF since 2017. The PolExPIR study aimed to describe the real-world data (RWD) on the Polish experience of pirfenidone therapy in IPF with respect to safety and efficacy profiles. Methods This was a multicentre, retrospective, observational study collecting clinical data of patients with IPF receiving pirfenidone from January 2017 to September 2019 across 10 specialized pulmonary centres in Poland. Data collection included baseline characteristics, pulmonary function tests (PFTs) results and six-minute walk test (6MWT). Longitudinal data on PFTs, 6MWT, adverse drug reactions (ADRs), treatment persistence, and survival were also collected up to 24 months post-inclusion. Results A total of 307 patients receiving pirfenidone were identified for analysis. The mean age was 68.83 (8.13) years and 77% were males. The median time from the first symptoms to IPF diagnosis was 15.5 (9.75–30) months and from diagnosis to start of pirfenidone treatment was 6 (2–23) months. Patients were followed on treatment for a median of 17 (12–22.75) months. Seventy-four patients (24.1%) required dose adjustments and 35 (11.4%) were chronically treated with different than the full recommended dose. A total of 141 patients (45.92%) discontinued therapy due to different reasons including ADRs (16.61%), death (8.79%), disease progression (6.51%), patient’s own request (5.54%), neoplastic disease (3.91%) and lung transplantation (0.33%). Over up to 24 months of follow-up, the pulmonary function remained largely stable. The median annual decline in forced vital capacity (FVC) during the first year of pirfenidone therapy was −20 ml (−200–100) and during the second year was −120 ml (−340–30). Over a study period, 33 patients (10.75%) died. Conclusions The PolExPIR study is a source of longitudinal RWD on pirfenidone therapy in the Polish cohort of patients with IPF supporting its long-term acceptable safety and efficacy profiles and reinforce findings from the previous randomised clinical trials and observational studies.

Introduction: The aim of this study was to assess the therapeutic effect and the safety of pre surgical treatment with long-acting octreotide in patients with acromegaly. Material and methods: This project was conducted in 25 centres across Poland as a non interventional, multicentre, observational study in patients with acromegaly, in which long-acting octreotide (Sandostatin® LAR®) was administered before surgery. They were 148 patients included into the study: 88 females and 60 males aged 18–86 years (51.3 ± 13.4). Results: Eighty patients completed the study (underwent tumour surgery). The CRF included: baseline visit, four follow-up visits every three months before surgery, and two follow-up visits every three months after surgery. Sandostatin® LAR® was administered every four weeks. The efficacy measures were as follows: change of growth hormone (GH) and insulin-like growth factor 1 (IGF-1) levels, number of patients fulfilling criteria of cure, and change of adenoma (micro- and macroadenomas) size during the treatment. Normalisation of GH and IGF-1 concentrations were obtained in 42.4 and 49.1% of patients at the end of medical therapy, respectively. Normalisation of GH and IGF-1 concentrations were obtained in 77.9 and 83.8% of patients after surgery, respectively. Reduction of microadenoma size was documented in 58.8% of patients, and in 70% of patients with macroadenomas at the end of medical therapy. In 74.0% of patients no pituitary tumour was shown on MRI after surgery. Conclusion: In conclusion, we have shown good surgical outcome in patients with acromegaly after pre-treatment with somatostatin analogue, and good tolerance and safety of the therapy, supporting the national recommendation for pre-surgical treatment with longacting somatostatin analogues in acromegaly patients.

Aspirin (ASA) is widely used as an antiplatelet therapeutic drug in secondary prevention. Last years brought many reports on ASA resistance or high on-treatment platelet reactivity (HTPR) to aspirin.This study is a post-hoc prospective analysis with 30 patients evaluated during follow up on average of 6.3 years after hospitalization from myocardial infarction. The examined population was divided into two subgroups according to the response to ASA. In order to estimate the function of blood platelets and their responsiveness to acetylsalicylic acid therapy, ASPI-test was used. The measurements were performed by the method of whole blood impedance aggregometry. During long-term follow up significantly higher percentage of high platelet reactivity was observed, compared with previous visits (p = 0.00001). Considering clinical endpoints of the research that were connected with coronary disease, no differences were obtained.The frequency of HTPR to aspirin in this study was higher than data reported in literature among subjects with CV diseases. In long-term observation the highest percentage of ASA non-responders was reported (58.6%). HTPR to aspirin did not affect the presence of the clinical endpoints for the study.

Surgical procedure has immense impact on the immune balance. However, little is known about perioperative changes in T regulatory and Th17 lymphocyte subpopulations in patients undergoing colorectal resection. Patients with resectable colon cancer were enrolled in the study. Blood samples were obtained on two occasions, i.e. before the procedure and two days after the surgery. We also recruited a control group of young, healthy individuals. Lymphocyte subpopulations were analyzed with the use of flow cytometry. Investigated subpopulations consisted of total lymphocyte count, CD4+, CD8+, T regulatory Foxp3+ (Tregs), Th17 lymphocytes and white blood cell (WBC) count. There were significant differences in immune cell levels before and after the surgery. Reduction was recorded in the CD4+, CD8+, Tregs and total lymphocyte counts (p=0.002, p=0.01, p=0.008 and p=0.001, respectively). Increase was observed in total WBC and Th17 cells, however, Th17 lymphocytes did not reach statistical significance (p=0.01 and p=0.5, respectively). In conclusion, surgical intervention caused changes in all lymphocyte subpopulations investigated in patients undergoing surgery for colorectal cancer. However, it seemed to be an effect of perioperative trauma. Further studies are needed to investigate the impact of surgical intervention on lymphocyte subpopulations., Kirurški zahvat ima golem učinak na ravnotežu imunog sustava. Međutim, malo se zna o perioperacijskim promjenama u subpopulacijama T regulatornih i Th17 limfocita u bolesnika podvrgnutih resekciji kolorektuma. U istraživanje su bili uključeni bolesnici s resektabilnim karcinomom kolona. Uzorci krvi prikupljeni su dva puta: prije zahvata i dva dana nakon operacije. Uključena je bila i kontrolna skupina sastavljena od mladih i zdravih osoba. Subpopulacije limfocita analizirane su protočnom citometrijom. Istraživane su sljedeće subpopulacije: ukupan broj limfocita, CD4+, CD8+, T regulatorni Foxp3+ (Tregs), Th17 i bijela krvna slika. Utvrđene su značajne razlike u razinama imuno stanica prije i nakon operacije. Snižene razine zabilježene su za CD4+, CD8+, Tregs i ukupni broj limfocita (p=0,002, p=0,01, p=0,008 odnosno p=0,001). Povišenje je zapaženo za bijelu krvnu sliku i Th17 stanice, međutim, Th17 limfociti nisu postigli statističku značajnost (p=0,01 odnosno p=0,5). Zaključujemo da je kirurški zahvat uzrokovao promjene u svim istraživanim subpopulacijama limfocita kod bolesnika podvrgnutih operaciji kolorektalnog karcinoma. Međutim, čini se da je to bio učinak perioperacijske traume. Potrebna su daljnja istraživanja kako bi se ispitao utjecaj kirurškog zahvata na subpopulacije limfocita.

Introduction Graves’ disease is the most common cause of hyperthyroidism, and orbitopathy is the most frequent extrathyroidal manifestation of Graves’ disease. The aims of this study were as follows: (1) to evaluate the serum concentration of HGF and IL-8 in the blood of newly diagnosed Graves’ disease patients with the first episode of active GO and healthy controls; (2) to estimate the influence of the thyroid function (euthyreosis vs. hyperthyreosis) on HGF and IL-8 blood levels in patients with active GO; (3) to evaluate the influence of intravenous (i.v.) methylprednisolone (MP) pulse therapy and additional oral MP treatment on HGF and IL-8 blood levels in patients with active GO. Patients and methods Thirty-nine Graves’ disease patients with the first episode of clinically active GO (Group A) were enrolled in the study. To estimate the influence of the thyroid function on serum concentrations of the studied proangiogenic factors, Group A was divided into Group A I (n = 18) in euthyroid and Group A II (n = 21) in hyperthyroid stage of Graves’ disease in moderate-to-severe stage of GO. The control group consisted of 20 healthy volunteers age- and sex-matched to the GO group. Concentrations of the studied proangiogenic factors in serum samples were measured by an enzyme-linked immunosorbent assay before (Group A) and after (Group A1) intensive pulse i.v.MP treatment and 1 month after the end of additional oral MP treatment (Group A2). Results We found a significant increase in serum concentrations of studied factors in the GO group before immunosuppressive therapy when compared with the control group and decrease after i.v.MP treatment. One month after the end of additional oral MP treatment (Group A2), serum concentrations of HGF and IL-8 still decreased and no significant difference was observed in HGF and IL-8 concentrations when compared with the control group. We did not find the difference in serum concentration of the studied proangiogenic factors between patients in euthyroid and hyperthyroid stage of Graves’ disease before MP therapy. Conclusions Serum HGF and IL-8 concentrations are elevated in Graves’ disease patients with active Graves’ orbitopathy as compared to the healthy control group. Successful management of active Graves’ orbitopathy with glucocorticoids is associated with a decrease in HGF and IL-8 serum concentrations.

Hyperhomocysteinemia is considered an independent risk factor for atherosclerosis and thrombosis. The purpose of this study was to evaluate plasma homocysteine, red blood cell folate, plasma folate, and plasma vitamin B12 concentration in patients with exudative age-related macular degeneration (ARMD).The participants of this study included 30 patients aged 60 to 71 years (mean age 66.2+/-3.6) with exudative ARMD. Plasma homocysteine levels were determined by high performance liquid chromatography (HPLC). Red blood cell folate, plasma folate, and plasma vitamin B12 concentration were determined using a standard kit (Dualcount Solid Phase No Boill radioassay kit for B12/folic acid, DPC Diagnostic, USA) by radioassay method.The plasma concentration of Hcy (14.88+/-6.23 micromol/L) in ARMD patients was significantly increased (p0.0001) compared with the control group (8.72+/-3.34 micromol/L). We found not a significant decrease of the plasma vitamin B12 concentration in the ARMD group (476.88+/-220.91 pg/mL) compared with the control group (527.08+/-208.97 pg/mL). Red blood cell folate (158.44+/-56.30 ng/mL) and plasma folate (6.5+/-3.4 ng/mL) in ARMD patients were also not significantly decreased when compared with the control group (183.86+/-59.33 ng/mL and 7.93+/-5.05 ng/mL).Hyperhomocysteinemia might be one of the risk factors for the exudative form of ARMD.

Tobacco smoking is the single most important modifiable factor in increased morbidity and premature mortality. Numerous factors—including genetics, personality, and environment—affect the development and persistence of tobacco addiction, and knowledge regarding these factors could improve smoking cessation rates. This study compared personality traits between never, former, and current smokers, using the Five-Factor Model of Personality in a country with a turbulent smoking reduction process.: In this cross-sectional study, 909 Polish adults completed the Revised Neuroticism-Extraversion-Openness Personality Inventory. Our results showed that current smokers’ scores for extraversion, one of the five global dimensions of personality, were higher relative to never smokers. Neuroticism, openness to experience, agreeableness, and conscientiousness did not differ significantly according to smoking status. Facet analysis, which described each dimension in detail, showed that current smokers’ activity and excitement seeking (facets of extraversion) scores were higher relative to those of never and former smokers. In turn, current smokers’ dutifulness and deliberation (facets of conscientiousness) scores were lower than those found in former and never smokers. Never smokers scored the highest in self-consciousness (a facet of neuroticism) and compliance (a component of agreeableness). The study conducted among Polish individuals showed variation in personality traits according to their smoking status; however, this variation differed from that reported in countries in which efforts to reduce smoking had begun earlier relative to Poland. Knowledge regarding personality traits could be useful in designing smoking prevention and cessation programs tailored to individuals’ needs.

Introduction: Thyroid orbitopathy (TO) is the most frequent extrathyroid manifestation of Graves’ disease. The aim of this study was to evaluate the serum concentration of Vascular Endothelial Growth Factor (VEGF), Plated-Derived Growth Factor-AA (PDGF-AA) in the blood of patients with active OT before and after immunosuppressive therapy. Patients and Methods: The study was performed in group of 39 patients with clinically active TO (Group A) in euthyroid (n=18, Group A I) and hyperthyroid (n=21, Group A II) stage of Graves’ disease in moderate or severe stage of TO. Control group consist of 20 healthy age-matched control subjects. Concentration of studied proangiogenic factors in serum samples were measured by an enzyme linked immunosorbent assay (ELISA) before (group A) and after (group A1) intensive pulse methylprednisolone treatment and one month after the end of additional oral methylprednisolone treatment (Group A2). Results: We have found significant increased serum levels of VEGF in patients with TO (reg­ardless to treatment) when compared with control group (542.4±328.1 pg/ml vs. 94.6±55.3 pg/ml, p=0.0002) and increased serum levels of ­PDGF-AA in patients before treatment (3 173.6±1 480.3 pg/ml) in comparison with controls (1 768.9±520.0 pg/ml) and patients after intensive pulse methyloprednisolone treatment (2 325.9±1 456.8 pg/ml). One month after the end of additional oral methylprednisolone treatment (Group A2) concentration of PDGF-AA still decreased and were was not significant difference with value in control group (1 853.1±795.4 vs. 1 769.9±520.0 pg/ml, p=0.99). Serum concentration of VEGF was still significantly higher compared with control. We have not observed difference in serum concentration of studied proangiogenic factors between patients in euthyroid or hyperthyroid stage of Graves’ disease. Conclusions: Results of the present study confirm the fact that angiogenesis could play a role in pathogenesis of thyroid orbitopathy.

The recent studies demonstrated that obese heart failure patients have better prognosis - "obesity paradox". The aim of the study was to evaluate the relationship between body mass index (BMI), leptin and adiponectin concentrations and prognosis in patients with heart failure due to non ischeamic dilated cardiomyopathy (NIDCM).128 patients with NIDCM were included and followed-up for three years. Leptin and adiponectin were measured at baseline using commercially available ELISA tests. Clinical data, routine laboratory parameters, NT-proBNP were assessed as risk factors for reaching the study endpoints: urgent heart transplantation (B), death (C), or combined endpoint death or urgent heart transplantation (D).Patient with adverse outcome had lower BMI and higher NT-proBNP concentration. Leptin was significantly elevated in group C and adiponectin was higher in groups B and D than in survived patients. Patients with leptin concentration below median or with adiponectin concentration above median were more often transplanted in three years follow-up (p = 0.029, p = 0.022, respectively). The cumulative probability of death was greater in patients with concentration of leptin above median (p = 0.024). In the multivariable Cox proportional hazards analyses, increasing leptin and lower BMI were predictors of death. Adiponectin was associated with higher risk of heart transplantation. Both an inverse association of BMI and positive association of leptin and adiponectin with combined endpoint were discovered. Further adjustment to established risk factors abolished association between combined endpoint and BMI, and modestly attenuate with adiponectin and leptin concentration.Evaluation of adiponectin and leptin concentrations was more useful than BMI in prediction of unfavourable outcome in patients with NIDCM. (Endokrynol Pol 2017; 68 (1): 26-34).

Background: Insect venom allergy (IVA) is present in 1–3% of the population. A group of patients with high specific IgE do not react to stings. In contrast, a proportion of patients with IVA have low specific IgE levels. These findings indicate that factors other than specific IgE may also be involved in IVA. Dysfunction of the renin-angiotensin system (RAS) has been described as a potential factor in IVA. The objective of this study was to determine the prevalence of angiotensin AGT p.M235T and angiotensin-converting enzyme ACE I/D, I/I, D/D gene polymorphisms in patients with IVA and to relate the presence of these gene variants to the course of IVA and the safety of treatment. Methods: A total of 107 patients with IVA and 113 controls were studied. AGT p.M235T and ACE (ID, I/I, D/D) gene polymorphisms were examined, and angiotensin I levels were measured by immunoassay. Results: The frequency of the AGT MM M235T variant was significantly higher in IVA patients (29.9%) than in controls (17%, p = 0.02). The presence of the MM M235T genotype increased the risk of grade IV reactions (odds ratio = 2.5 and 95% confidence interval 1.04–6.08). There were no differences in the prevalence of the ACE I/D polymorphism and angiotensin I levels between control groups and patients with different grades of anaphylactic reactions or patients with side effects of venom immunotherapy. Conclusion: The AGT M235T MM variant may be responsible for severe anaphylactic reactions to insect venom allergens in some patients.

The aim of this study was to evaluate the ferric-reducing ability of serum (FRAS), paraoxonase 1 (PON1), ceruloplasmin serum oxidase activity and hsCRP level in patients with type1 diabetes mellitus without and with diabetic retinopathy. The study was performed in 76 patients with type 1 diabetes mellitus, 35 without diabetic retinopathy (group 1) and 41 with preproliferative and proliferative retinopathy (group 2). Control group consisted of 35 nondiabetic, age-, gender-, body mass-matched healthy volunteers who came to the outpatient clinic for a routine health check-up. We evaluated FRAS using the method described by Benzie and Strain; PON1 by kinetic spectrophotometric assay with paraoxon as substrate and ceruloplasmin using its oxidative activity with 3-phenylenodiamine as substrate. CRP was measured with a high sensitive enzyme immunoassay. PON1 activity was significantly decreased in patients with diabetic retinopathy (227.66 +/- 123.57 U/l) when compared with control (312.04 +/- 129.77 U/l). FRAS was significantly decreased in group 2 (439.33 +/- 79.87 micromol/l) when compared with group 1 (522.79 +/- 167.56 micromol/l) and control (529.80 +/- 81.99 micromol/l). Ceruloplasmin activity was significantly elevated in group 1 (58.36 +/- 22.56 U/g protein) when compared with control (45.22 +/- 14.96 U/g protein). We have found significant increase in hsCRP level in group 2 (3.71 +/- 2.47 mg/l) when compared with group 1 (1.75 +/- 1.01 mg/l) and control (0.57 +/- 0.46 mg/l). The PON1/CRP ratio in control group was significantly increased when compared with diabetic patients and was significantly decreased in group 2 compared with group 1. We have not found gender-dependent difference in studied parameters in both control and in study groups. We have found tendency to decrease the serum activity of FRAS and hsCRP in elder patients but the difference was significant only in group 2. FRAS and PON 1 activity is decreased in patients with type 1 diabetes mellitus with presence of diabetic retinopathy which confirms that oxidative stress could play a role in pathogenesis of diabetic retinopathy. Significantly elevated levels of hsCRP in diabetic patients with the presence of diabetic retinopathy compared with patients without diabetic retinopathy providing a link between inflammation and the development of microvascular complication of diabetes. Because of the significant difference in PON1/CRP ratio between patients without and with the presence of diabetic retinopathy, it seems that PON1:CRP ratio may be used as a biochemical marker for progression of retinopathy. The link between the antioxidant concentration, inflammation and the development of diabetes complications needs further longitudinal studies in order to confirm our findings.

This study was undertaken to determine whether serum adiponectin and resistin levels are influenced by hyperthyroidism and autoimmune factors and to find out whether their levels are dependent on the presence of ophthalmopathy. We measured serum concentrations of adiponectin and resistin in 76 patients (63 women, 13 men) with Graves' disease (GD) and compared them with levels of the control group which consisted of 30 healthy subjects. Patients were separated into two groups according to the presence or the absence of thyroid-associated ophthalmopathy (TAO). TAO (-) group consisted of 26 subjects without eye signs of GD and TAO (+) group included 50 subjects with ophthalmopathy. The latter group was further divided into 2 subgroups: with active TAO [26 patients, clinical activity score (CAS)or =4] and with inactive TAO (24 patients, CAS4). Groups did not differ in age, sex, body mass index (kg/m2) and smoking habits. Compared with euthyroid subjects, hyperthyroid GD patients had elevated mean serum adiponectin concentrations (19.96+/-4.97 microg/ml vs 15.01+/-3.99 microg/ml, p0.001). However we did not observe any disparity between the TAO (-) and TAO (+) groups (20.60+/-5.06 microg/ml vs 19.63+/-4.94 microg/ml, p=ns). Comparing patients with a CASor =4 and patients with a CAS4, we found similar mean serum concentrations of adiponectin (20.04+/-5.01 microg/ml vs 18.74+/-4.83 microg/ml, p=ns). Serum levels of resistin did not differ between the hyperthyroid patients and control subjects (13.11+/-4.26 ng/ml vs 12.82+/-4.75 ng/ml, p=ns). Serum resistin levels did not differ between TAO (+) and TAO (-) groups nor in patients with active and inactive TAO. Serum adiponectin correlated significantly with free T4 (FT4), free T3 (FT3), and TSH-R antibodies (TRAb) in GD patients (r=0.40, 0.41, and 0.37, respectively; p0.001 for each). Serum resistin levels were not correlated with thyroid hormones and thyroid antibodies. The variables that in simple linear regression analyses were found to be correlated with serum adiponectin were then used in multiple regression analysis. In a model including adiponectin as dependent variable and FT4, FT3 and TRAb levels as independent variables, FT3 and TRAb remained as parameters independently related to adiponectin level (R2=0.35, p0.001).Elevated serum adiponectin levels in GD patients are related to the degree of hyperthyroidism and autoimmune process. The presence and activity of ophthalmopathy is not a modifier of serum adiponectin and resistin.

Background: The safety profile of venom immunotherapy is a relevant issue. We evaluated the frequency of severe adverse events (SAE), associated risk factors, retrospective comparison of pretreatment protocols including solely H1 receptor blockers and a combination of H1 and H2 receptor blockers during rush Hymenoptera venom immunotherapy. Methods: The study group comprised 118 patients. The treatment was initiated according to a 5-day rush protocol with the use of standardized venom allergens of either wasp or honeybee. Results: During the rush induction, side effects occurred in 18 patients (15.2%), whereas SAE were present in 7 patients (5.9%). Twelve out of 18 (66.6%) developed anaphylactic reactions on the fourth day of the rush protocol, with the majority of cases at a dose of 40 or 60 µg of the venom extract (p = 0.001). The frequency of SAE was also significantly higher on the fourth day than thereafter (p = 0.0001) as well as in patients allergic to bee venom (p = 0.049). All systemic side effects were more frequent in women (p = 0.0065). However, this relation was not true when SAE were consider (p = 0.11). A higher percentage of SAE was observed in the subjects pretreated with both H1 and H2 receptor antagonists than in those pretreated with H1 blocker only (8.8 vs. 4.1%); however, the difference was not significant. Conclusions: Considerable severity of allergic adverse events requires particular attention to patients allergic to bee venom and during rush phase, especially when rapidly increasing doses are administered. Pretreatment with H2 blockers is debatable and warrants further investigation.

The prevalence of metabolic syndrome increases after menopause; however, the role of concomitant subclinical hypothyroidism has not been completely elucidated. The aim of the study was to identify associations between thyrotropin, immune status, inflammation, and metabolic syndrome in postmenopausal women. The specific goals were: to assess thyrotropin (TSH) and interleukin-6 (IL-6) concentrations in the serum of subclinical hypothyroid postmenopausal women with and without metabolic syndrome and compare them with euthyroid controls; to test whether immune status is related to metabolic syndrome in postmenopausal women and determine the role of IL-6; to examine the relationships between TSH and different features of metabolic syndrome: insulin resistance, waist circumferences, waist-to-hip ratio (WHR), BMI, metabolic parameters (triglycerides, total cholesterol and high-density lipoprotein cholesterol), and inflammatory cytokines (IL-6).Three hundred and seventy-two postmenopausal women were included in the study: 114 women had subclinical hypothyroidism (10.0 uIU/mLTSH ≥ 4.5 uIU/mL, normal fT4), and 258 women were in euthyreosis (TSH 0.35-4.5 uIU/mL, normal fT4); both groups were matched by age. Anthropometric measurements were conducted (BMI, waist circumference, WHR) and blood pressure was measured. In all subjects the following were assessed in serum: lipid profile, glucose, insulin, TSH, fT4, thyroid antibodies (T-Abs) - TPO-Abs, TG-Abs, and IL-6 concentrations.The prevalence of metabolic syndrome was 49.12% in subclinical hypothyroid women and 46.89% in euthyroid women. However, the proportion of subjects with one or two abnormalities was significantly higher in the subclinical hypothyroid group (45.61%) than in the euthyroid group (32.17%). When we compared subclinical hypothyroid women with and without metabolic syndrome, subjects with metabolic syndrome had higher BMI, abdominal circumferences, WHR, and HOMA-I. They presented higher systolic and diastolic blood pressure. Serum concentrations of cholesterol, triglycerides, fasting glucose, IL-6, TSH, T-Abs were also higher and serum cHDL was lower. There were no significant differences in fT4 concentrations. A similar comparison was made for euthyroid women with and without metabolic syndrome. Higher BMI, waist circumference, WHR, HOMA-I, and systolic blood pressure were observed in subjects with metabolic syndrome. Serum concentrations of TSH, triglycerides, glucose, and IL-6 were also higher, but the concentration of cHDL was significantly lower. There were no significant differences in fT4, T-Abs, cholesterol levels, and diastolic pressure. When we compared euthyroid women T-Abs (+) and T-Abs (-), the prevalence of metabolic syndrome was similar (48.68% vs. 46.15%). There were no differences in BMI, waist circumference, WHR, lipid profile, glucose, and HOMA-I, fT4. However, thyroid autoimmunity was associated with elevated TSH and IL-6 levels. When we analysed subclinical hypothyroid women with and without thyroid autoimmunity, there were no significant differences in glucose and lipid profile. However, Hashimoto`s subjects were more obese, had higher waist circumference, WHR, HOMA-I, and higher prevalence of metabolic syndrome. Serum concentrations of TSH and IL-6 were also higher and fT4 was lower. Among all of the women, serum TSH concentration was significantly correlated with BMI, waist circumference, WHR, systolic blood pressure, cholesterol, triglycerides, and TPO-Abs. When the variables of subjects with upper quartile of TSH were compared with lower quartile of TSH, we found significantly higher BMI, waist circumference, WHR, increased concentration of IL-6, cholesterol, triglycerides, and T-Abs, and concentrations of cHDL and fT4 were lower. OR for metabolic syndrome in subjects with upper quartile TSH vs. lower quartile was 1.35 (95% confidence interval [CI] 1.10-1.60).Our study confirms that metabolic syndrome in both euthyroid and subclinical hypothyroid women is connected with obesity, visceral fat accumulation, and higher TSH and IL-6 concentrations. Immune thyroiditis is associated with higher TSH and IL-6 levels. Obese subclinical hypothyroid women with Hashimoto`s thyroditis have a higher prevalence of metabolic syndrome when compared with subclinical hypothyroid women without thyroid autoimmunity. It is possible that in the crosstalking between subclinical hypothyroidism and metabolic syndrome, enhanced proinflammatory cytokine release in the course of immunological thyroiditis plays a role.

Background Tobacco use is a complex, multistage behaviour. The particular stages of this behaviour, including nicotine dependence (ND), are influenced by both genetics and the environment. Surveys on factors influencing tobacco use and ND, conducted in ethnically homogenous populations, can provide results less influenced by genetic and cultural heterogeneity. We aimed to assess ND in a sample of current smokers, derived from the geographically and culturally isolated population of Kashubians from North Poland, and evaluate its potential association with age, sex, and self-reported comorbidities. In addition, we attempted to replicate - for the first time in this population - previous findings on the association between ND and several variants within the CHRNA5A3-A5-B4 nicotine receptor subunit gene cluster. Methods The study sample consisted of 969 unrelated subjects who were all current smokers. ND was evaluated using four measures: the Fagerstrom Test for Nicotine Dependence (FTND), the Heavy Smoking Index (HSI), the number of cigarettes per day (CPD) and the time to first cigarette after waking (TTF). All subjects underwent genotyping for CHRNA5 rs16969968, CHRNA3 rs578776, and CHRNB4 rs12914008 variants. Multivariate regression analysis was used for the assessment of the studied correlations. A significance level of 0.05 with the Bonferroni correction for multiple testing was set for a type 1 error in the analyses. Results The mean CPD, FTND and HSI scores in the study sample were 17.3 ± 7.7, 3.9 ± 2.3 and 2.6 ± 1.5, respectively. No association between ND defined by FTND, HSI or TTF and age was found. In turn, heavy smoking was significantly associated with older age (odds ratio (OR) = 1.72, 95% confidence interval (CI): 1.14-2.59, p = 0.009), and men were more likely than women to be heavy smokers (OR = 1.70, 95% CI: 1.09-2.65, p = 0.018). Chronic comorbidity did not significantly influence ND. An analysis of association of studied polymorphisms with ND showed a borderline association of rs16969968 with CPD (OR = 1.63, 95% CI: 1.09–2.45, p = 0.017). Conclusion Our study showed a low to moderate level of ND in the Kashubians, influenced by age, sex, as well as the CHRNA5 rs16969968 variant.

Tobacco smoking continues to be a leading cause of disease and mortality. Recent research has confirmed the important role of nicotinic acetylcholine receptor (nAChR) gene cluster on chromosome 15q 24-25 in nicotine dependence and smoking. In this study we tested the association of smoking initiation, age at onset of daily smoking, and heaviness of smoking with five single nucleotide polymorphisms (SNPs) within the CHRNA5-CHRNA3-CHRNB4 cluster. The group of 389 adult subjects of European ancestry from the north of Poland, including 212 ever (140 current and 72 former) and 177 never smokers with mean age 49.26, was genotyped for rs16969868, rs1051730, rs588765, rs6495308, and rs578776 polymorphisms. Distributions of genotypes for rs16969868 and rs1051730 were identical so they were analyzed together. Further analysis revealed the association between rs16969868-1051730 (OR = 2.66; 95% CI: 1.30–5.42) and number of cigarettes smoked per day (CPD) with heaviness of nicotine addiction measured by the Fagerström Test for Nicotine Dependence (FTND) (OR = 2.60; 95% CI: 1.24–5.43). No association between these polymorphisms and other phenotypes was found. Similarly, the association between rs588765, rs6495308, rs578776, and analyzed phenotypes was not confirmed. This study provides strong evidence for the role of the CHRNA5-CHRNA3-CHRNB4 cluster in heaviness of nicotine addiction.

Gastroenteropancreatic neuroendocrine tumours (GEP NETs) are a heterogenous group of tumours of various clinical presentations. Proliferative activity of tumour cells is an essential parameter determining the course of the disease and affecting the prognosis. The Ki-67 antigen is an important marker of cell proliferation, which shows activity in all the phases of the cell cycle, excluding the G0 phase.To assess the expression of Ki-67 in GEP NETs and to examine the association of Ki-67 with the stage of the tumour (tumour size, presence of metastases) and the hormonal function of the tumour.We included 61 patients with GEP NETs (25 males and 36 females aged between 20 and 82 years [mean age: 56 years]). The proliferative activity was examined in paraffin blocks containing surgically removed tumour samples and in core-needle biopsies of primary and metastatic tumours. The presence of the Ki-67 antigen was assessed by immunohistochemistry using MIB‑1 monoclonal antibodies. Based on the Ki-67 proliferative index we determined the tumour grade. In addition, we determined the tumour stage according to the TNM classification. In all the subjects we determined the levels of the non-specific NET marker (chromogranin A) and of specific NET markers (serotonin, insulin and gastrin in the blood and 5‑hydroxyindoleacetic acid [5‑HIAA] in 24-hour urine).The diagnoses of low-grade (Ki‑67 ≤ 2%), intermediate-grade (Ki-67 3-20%) and high-grade (Ki‑6720%) NET were established in 38, 12 and 11 patients, respectively. Metastatic disease was diagnosed in 36/61 patients. A significantly higher expression of K-67 was observed in patients with metastatic disease (p = 0.01). A positive correlation was demonstrated between Ki-67 and the stage of the disease (p = 0.01) and between the histologic grade of the tumour and the stage of the disease (p = 0.01). No association between Ki-67 and the levels of chromogranin A, serotonin, insulin, gastrin and 5-HIAA was shown. There was also no difference in Ki-67 expression relative to the location of the primary tumour and the tumour size.The Ki-67 proliferative index is an essential parameter predicting the course of GEP-NETs.

Stroke, due to its worldwide prevalence, is not only a medical challenge, but also a serious social problem. Recently, ongoing research has examined whether there are associations between adipose tissue hormones and the risk, mechanisms and course of stroke. The aim of our study was to determine whether there are significant differences in blood concentrations of insulin, adiponectin, leptin, resistin and in insulin resistance among patients in the acute phase of ischaemic stroke, compared to healthy subjects. In addition, we wanted to investigate if those biochemical values show a correlation with the neurological condition of our patients.Adiponectin, leptin, resistin and insulin were measured in patients (n = 69) with first-ever ischaemic stroke (confirmed by CT), using specific electrochemoluminescence, radioimmunoassay and ELISA methods. Neurological evaluation was performed using Barthel ADL index on the day of admission and on the ninth day of hospitalisation. Insulin resistance value was obtained via the HOMA-IR calculator. Data was compared to that of healthy individuals (n = 26).Insulin concentration (51.08 v. 17.02 uU/mL) and HOMA-IR value (6.3 v. 2.2) were significantly higher in the study group. Leptin (14.98 v. 10.47 ng/mL) and resistin (28.92 v. 12.25 ng/mL) levels were elevated among the stroke survivors compared to controls, but no significant difference was noted in adiponectin. Negative correlations of adiponectin level and Barthel score were observed.Hyperinsulinaemia and insulin resistance are involved in the pathogenesis of ischaemic stroke. Hyperleptinaemia and hyperresistinaemia play a role in the mechanism of stroke. The severity of stroke is associated with adiponectin blood concentration.

Graft-versus-host disease (GVHD) is the most common and most serious complication of allogeneic hematopoetic stem cell transplantation (HSCT). The aim of this study was to assess the incidence of GVHD after allogeneic HSCT depending on the diagnosis and risk factors.The study group comprised 78 patients aged 18 to 61 in whom allogeneic transplantation of hematopoietic stem cell in the Department and Clinic of Hematology, Oncology and Internal Diseases of Medical University in Warsaw (Poland) was performed.Acute form of GVHD was significantly more often occurred after total body irradiation (TBI) for patients with TBI who did not (p0.05).Risk factors for aGVHD were: age of the recipient, acute myeloid leukemia, myeloablative conditioning, TBI and unrelated donor.

Several studies have assessed natriuretic peptides in patients with thyroid disorders, and these studies have provided contrasting results. This difference may be partially explained by the presence of concomitant disorders of the cardiovascular system in participants.The study included 101 patients free of any cardiovascular disorder, who, on the basis of plasma levels of TSH and thyroid hormones, were divided into patients with overt hyperthyroidism, patients with subclinical hyperthyroidism, patients with overt hypothyroidism, patients with subclinical hypothyroidism, and control subjects with normal thyroid profile. Hyperthyroidism was induced either by nodular thyroid disease or by Graves' disease, while hypothyroidism was secondary to autoimmune thyroiditis or surgery.Compared to control subjects, hyperthyroid patients were characterised by higher plasma levels of NT-pro-BNP. This increase was particularly pronounced in cases of overt disease. On the other hand, neither clinical nor subclinical hypothyroidism was associated with any significant changes in this peptide. Plasma levels of NT-pro-BNP did not differ between patients with Graves' disease and toxic nodular goitre nor between patients with autoimmune hypothyroidism and hypothyroidism secondary to thyroidectomy. Only L-thyroxine substitutions, but not hyperthyroidism treatment, caused changes in plasma concentration of NT-pro-BNP.Hyperthyroidism and hypothyroidism induce changes of the plasma concentration of NT-pro-BNP. Although both exogenous L-thyroxine and antithyroid drugs restored thyroid function, only the former drug changed plasma NT-pro-BNP content. The thyrometabolic state of a patient should always be taken into consideration when NT-pro-BNP is assessed as a marker of cardiac dysfunction.

The authors presents the review of the literature concerning on the signs, classification, connections between the dry eye syndrome and other diseases and the risk factors of dry eye syndrome. It is a prevalent, multifactorial disease that is particularly frequent in elderly patients and women, especially in menopausal and postmenopausal period. Dry eye syndrome can be episodic with transient signs and symptoms or chronic with persistent signs and symptoms and is characterized by one or more of the following symptoms: burning, itching, foreign body sensation, soreness, dryness, photophobia, redness, and reduced visual acuity. The tear film instability of dry eye syndrome, which is accompanied by increased osmolarity of the tear film, causes inflammation and structural damage to the ocular surface. There are two major etiologic categories of dry eye syndrom: aqueous-deficient and evaporative. The most frequent classification of dry eye for practical clinical use is triple classification based on the ethiology, histopathological changes and severity of the disease.

A cross-sectional study investigated changes in patients’ value systems following a diagnosis of cancer. Fifty patients at 1 to 6 months following cancer diagnosis, were asked to compare their current values with their recollection of past values. Using the Rokeach Value Survey we obtained statistically significant results showing that twenty-seven out of thirty-six values changed their importance from the patients’ perspective: 16 values significantly increased, while 11 values significantly decreased in importance. Changes with respect to nine values were insignificant. We indentified clusters of values increasing in importance the most: Religious morality (Salvation, Forgiving, Helpful, Clean), Personal orientation (Self-Respect, True Friendship, Happiness), Self-constriction (Self-Controlled, Obedient, Honest), Family security (Family Security, Responsible), and Delayed gratification (Wisdom, Inner Harmony). We also observed that the following value clusters decreased in importance: Immediate gratification (An Exciting Life, Pleasure, A Comfortable Life); Self-expansion (Capable, Ambitious, Broadminded), Competence (A Sense of Accomplishment, Imaginative, Intellectual). The remaining values belonged to clusters that as a group changed slightly or not at all. Practical implications of the study are discussed.

Leptin and adiponectin are involved in the pathogenesis of several autoimmune diseases. Very little is known about adipocytokine production in autoimmune thyroid diseases. Interleukin-6 (IL-6) plays an important role in the inflammatory and autoimmune processes.The aim of this study was to assess the serum levels of leptin, adiponectin, and IL-6 in postmenopausal euthyroid women with Hashimoto's thyroiditis and compared them with concentrations in control women. Ninety-eight euthyroid women with Hashimoto's thyroiditis were enrolled in the study. The diagnosis was confirmed with elevated thyroid peroxidise autoantibody (TPOAb) levels in serum and typical hypoechogenic pattern on thyroid ultrasound. The control group, matched for body mass index (BMI), consisted of 105 healthy postmenopausal euthyroid women. Serum levels of leptin, adiponectin, IL-6, thyroid-stimulating hormone (TSH), free thyroxine (fT(4)), and TPOAbs were determined.When compared with controls, the women with Hashimoto's thyroiditis were characterized by significantly elevated serum concentrations of IL-6, whereas concentrations of leptin and adiponectin were not different. Hashimoto's thyroiditis patients had significantly higher serum levels of TSH than the controls. The simple linear regression analyses of the Hashimoto's thyroiditis group and all of the studied women indicated that serum leptin levels correlated positively with BMI, waist to hip ratio (WHR), TSH, and IL-6 and negatively with adiponectin. No correlation was observed between serum adiponectin and TSH, fT(4), or TPOAbs. There were no associations between serum IL-6 levels, TPOAbs, and TSH levels; however, positive correlations between IL-6 and BMI, WHR, and leptin were observed. TSH correlated positively with leptin, age, and TPOAbs.Hashimoto's thyroiditis is characterized by an increased production of IL-6 but does not have a direct influence on leptin or adiponectin serum levels. The correlations between TSH and leptin demonstrated in this study highlight the need for future investigations. (Pol J Endocrinol 2010; 61 (1): 112-116).

Background Polymorphisms in dopaminergic genes may influence cigarette smoking by their potential impact on dopamine reward pathway function. A1 allele of DRD2 gene is associated with a reduced dopamine D2 receptor density, and it has been hypothesised that A1 carriers are more vulnerable to smoking. In turn, the 9-repeat allele of dopamine transporter gene (SLC6A3) has been associated with a substantial reduction in dopamine transporter, what might result in the higher level of dopamine in the synaptic cleft, and thereby protective role of this allele from smoking. In the present study we investigated whether polymorphic variants of DRD2 and SLC6A3 genes and their combinations are associated with the smoking habit in the Polish population. Methods Genotyping for TaqIA polymorphism of DRD2 and SLC6A3 VNTR polymorphism was performed in 150 ever-smokers and 158 never-smokers. The association between the smoking status and smoking phenotypes (related to the number of cigarettes smoked daily and age of starting regular smoking), and genotype/genotype combinations was expressed by ORs together with 95% CI. Alpha level of 0.05, with Bonferroni correction whenever appropriate, was used for statistical significance. Results At the used alpha levels no association between DRD2 and SLC6A3 genotypes and smoking status was found. However, A1 allele carriers reported longer abstinence periods on quitting attempts than non-carriers (p = 0.049). The ORs for heavier smoking were 0.38 (0.17-0.88), p = 0.023, and 0.39 (0.17-0.88), p = 0.021 in carriers compared to non-carriers of A1 or *9 allele, respectively, and the OR for this smoking phenotype was 8.68 (2.47-30.46), p = 0.0005 for the A1-/9- genotype combination, relatively to the A1+/9+. Carriers of *9 allele of SLC6A3 had over twice a lower risk to start smoking before the age of 20 years compared to non-carriers (sex-adjusted OR = 0.44; 95% CI: 0.22-0.89; p = 0.0017), and subjects with A1-/9- genotype combination had a higher risk for staring regular smoking before the age of 20 years in comparison to subjects with A1+/9+ genotype combination (sex-adjusted OR = 3.79; 95% CI:1.03-13.90; p = 0.003). Conclusion Polymorphic variants of DRD2 and SLC6A3 genes may influence some aspects of the smoking behavior, including age of starting regular smoking, the level of cigarette consumption, and periods of abstinence. Further large sample studies are needed to verify this hypothesis.

The study investigated relationships of postoperative pain following coronary artery bypass graft (CABG) surgery with two variables: (1) level of preoperative anxiety (anxiety-state) and (2) level of anxiety-trait.Eighty three randomly selected male patients (44-66 years old), qualified for CABG surgery, participated in the study. All of them were patients at the Cardiosurgery Medical Centre of Pomeranian Medical University. It was a prospective clinical study. Anxiety-state and anxiety-trait were measured in the preoperative period using a Polish version of STAI. During the postoperative period the following factors of postoperative pain were measured, using a modified version of McGill Pain Questionnaire: average level of perceived postoperative pain, level of extreme pain, pain frequency, degree of pain regression following analgesia and number of other pain complaints.A significant relationship of the level of preoperative anxiety-state and anxiety-trait with the degree of pain regression within the postoperative wound following the administration of medication (analgesia efficiency) was found (p0.01 and 0.001, respectively). Additionally, a significant relationship was found between the level of anxiety-trait with the level of perceived extreme postoperative pain (p0.01) and with the number of other pain complaints (p0.1).This investigation confirmed that relationships of anxiety and pain reported in other research are true also for CABG patients. It has been also observed that patients with a high level of preoperative anxiety-state and stronger anxiety-trait respond worse to analgesic medication than patients with a low level of anxiety-state and anxiety-trait. Therefore, actions undertaken to reduce patients' anxiety may reduce patients' need of analgesic medications.

Background A better understanding of the genetic determinants of tobacco smoking might help in developing more effective cessation therapies, tailored to smokers' genotype. Insertion/deletion polymorphism in the promoter region of the serotonin transporter gene (5-HTTLPR) has been linked to vulnerability to smoking and ability to quit. We aimed to determine whether 5-HTTLPR genotype is associated with smoking behavior in Caucasians from Northern Poland and to investigate other risk factors for tobacco smoking. Methods 5-HTTLPR genotypes were determined in 149 ever smokers (66 females; mean age 53.0 years) and 158 gender and ethnicity matched never smoking controls (79 females; mean age 45.0 years) to evaluate the association of this polymorphism with ever smoking status. Analysis of smokers was performed to evaluate the role of 5-HTTLPR in the age of starting regular smoking, the number of cigarettes smoked daily, pack-years, FTND score, duration of smoking, and the mean length of the longest abstinence on quitting. Genotype was classified according to the presence or absence of the short (S) allele vs. the long (L) allele of 5-HTTLPR (i.e., S/S + S/L vs. L/L). Logistic regression analysis was also used to evaluate correlation between ever smoking and several selected variables. Results We found no significant differences in the rates of S allele carriers in ever smokers and never smokers, and no relationship was observed between any quantitative measures of smoking and the polymorphism. Multivariate analysis demonstrated significant association between the older age (OR = 4.03; 95% CI: 2.33–6.99) and alcohol dependence (OR = 10.23; 95% CI: 2.09–50.18) and smoking. Conclusion 5-HTTLPR seems to be not a major factor determining cigarette smoking in Poles. Probably, the risk of smoking results from a large number of genes, each contributing a small part of the overall risk, while numerous non-genetic factors might strongly influence these genetic undergrounds of susceptibility to smoking.

In the present study we assessed the impact of former cigarette smoking on asthma control and treatment effectiveness.A total of 104 patients with uncontrolled asthma were included in the study. The group of former smokers consisted of 33 subjects, whereas the never smokers group consisted of 71 subjects of similar age and gender. Spirometry, classification of asthma severity, and control were assessed according to Global Initiative for Asthma (GINA) guidelines. Quality of life was measured with the use of the Saint George Hospital Respiratory Questionnaire (SGHRQ).Asthma was more severe in the group of former smokers both before and after treatment; p0.001. Severe asthma (OR 7.8 CI 2.8-21.9) and cigarette smoking (OR 3.5 CI 1.3-9.2) were associated with difficulties in asthma control achievement. Total quality of life significantly improved in the group of non-smokers; p = 0.02, whereas in former smokers this effect was not significant; p0.05.Cigarette smoking has a persistent, dose-dependent, negative impact on the response to treatment in patients with uncontrolled asthma even after smoking cessation. Smoking cessation should remain the ultimate goal in treatment of asthmatic patients. More efforts should be undertaken to decrease smoking initiation, especially in teenagers.

The aim of this study was to evaluate the blood concentration of hepatocyte growth factor (HGF) in patients at various stages of retinopathy. We hypothesised that the high level of HGF found in diabetic patients may be an important marker of retinopathy progression and that HGF level may be an index of the risk of proliferative retinopathy.The participants in the study were 76 patients with type 1 diabetes mellitus. Of these, 35 patients were without retinopathy and formed Group 1. Of the remaining 41 patients with retinopathy, 20 patients had non-proliferative diabetic retinopathy (NPDR) and formed Group 2, while 21 patients had proliferative diabetic retinopathy (PDR) and formed Group 3. We evaluated the concentration of HGF In the peripheral blood by an enzyme-linked immunosorbent assay.Mean serum concentrations of HGF in the control group were significantly lower than in the type 1 diabetic patients. We found a significant increase in HGF serum concentrations in diabetic patients with PDR compared with the control group. Mean serum HGF concentrations were significantly higher in diabetic subjects with PDR than in diabetic patients without retinopathy.HGF concentration is increased in patients with type 1 diabetes mellitus with proliferative retinopathy, and concentrations increase with the progression of retinopathy, suggesting that HGF plays a role in the pathogenesis of proliferative diabetic retinopathy.

The work of A. J. Cunningham has created new perspectives for extension of survival through psychological intervention in patients with advanced cancer. Therapeutic techniques exploiting unique subjective psychic and social experiences may be particularly helpful at the time when life of the patient is threatened by an incurable disease. Psychological therapy should be based on an individual plan for living with cancer. Novel qualitative research and therapeutic methods need to be developed.

Some studies have found that people with type 2 diabetes mellitus are at increased risk of neoplasms, especially colorectal cancer (CRC). In other studies it is also suggested that there is a higher incidence of diabetes mellitus in patients with CRC. The aims of this study were to assess whether the incidence of type 2 diabetes mellitus and impaired glucose tolerance (IGT) are higher in subjects with CRC and to determine the difference between diabetic subjects and healthy controls regarding glucose metabolism (glycaemia, insulinaemia, serum levels of C-peptide) as well as insulin resistance and sensitivity.The study included a total of 80 subjects: 40 enrolled patients (20 M, 20 F) with newly diagnosed sporadic colorectal cancer and 40 subjects with endoscopically excluded CRC or adenomas serving as controls. Subjects were matched for gender, age and body mass index (BMI) (age +/- 5 years BMI +/- 1 kg/m2). A 75-g oral glucose tolerance test was performed after an overnight fast. Samples for glycaemia, serum levels of C-peptide and insulin were taken at 0, 30, 60, 90, 120 and 150 min of the study. HOMA-IR, EIR, EIR/HOMA-IR indexes were calculated.There was a significantly higher incidence of impaired glucose metabolism (IGM-diabetes mellitus or IGT) in CRC subjects. No differences were found in levels of glucose, insulin or C-peptide. Insulinaemia and C-peptide curves showed a shift typical of diabetes, in the form of a delayed insulin release peak. The HOMA-IR, EIR as well as the EIR/HOMA-IR indexes showed no differences between groups.A significantly higher incidence of IGM appears to occur in CRC patients than in the healthy population. This phenomenon is not dependent on age and body-weight, which may suggest that it is cancer that predisposes to diabetes rather than the other way round. The neoplastic process in the colon is not associated with hyperinsulinaemia or insulin resistance, but in CRC patients, pancreatic B-cell dysfunction typical of the early stages of diabetes is seen.

Neuroendocrine tumors are frequently associated with other primary malignancies. Plasmablastic lymphoma is a rare, aggressive neoplasm, derived from large B-cell, associated with human immunodeficiency virus infection. Plasmablastic lymphoma cells share many cytomorphologic and immunophenotypic features with plasmablastic cells, causing some diagnostic problems. We present a unique case of coexisting two very uncommon neoplasms: plasmablastic lymphoma and neuroendocrine carcinoma in 54-years-old men. This is the first report of caecum localization of plasmablastic lymphoma. Presented case images diagnostic problems in rare neoplasms.

It is well known that there is a higher prevalence of cardiovascular risk factors and metabolic syndrome (MS) in postmenopausal women. Recently it has become evident that adiponectin and leptin secreted by adipose tissue may be involved in the pathophysiology of MS.was to assess the effects of the menopause on the relationships between adiponectin and leptin and different cardiovascular and metabolic risk factors.A total of 56 postmenopausal women and 75 premenopausal subjects were enrolled in this study. We measured blood pressure, BMI, waist circumference and WHR, triglycerides (TG), high density lipoprotein cholesterol (cHDL) levels and fasting glucose and applied the oral glucose tolerance test (OGTT). Women were categorised as having 0, 1, 2, 3 or more risk factors. The presence of at least 3 abnormalities was defined as MS. Serum was assayed for adiponectin and leptin by the radioimmunoassay (RIA) method.A decline in adiponectin was related to an increased number of MS variables in postmenopausal and premenopausal women. Postmenopausal women with MS had significantly lower adiponectin concentrations than premenopausal women with MS. Serum adiponectin concentrations were inversely correlated to leptin in postmenopausal women. In premenopausal women no clear relationships were found between serum leptin and the number of metabolic disturbances. In contrast to young women, postmenopausal women showed an increase in leptin secretion with a growing number of MS elements. Compared to premenopausal women with MS, postmenopausal women with MS had higher levels of leptin. We found associations between leptin and different risk factors, mainly in the postmenopausal group. When the presence of MS was used as a dependent variable (yes/no) and adiponectin, leptin and menopause status as independent factors, adiponectin and leptin remained significant variables related to MS.The significant role of adiponectin in the pathophysiology of MS in premenopausal and postmenopausal women is confirmed in this study. Leptin is correlated with several MS components but this adipocytokine appears to play a role only in postmenopausal women.

Dry eye symptoms and tear film profile were examined in 21 patients with Graves' disease complicated by active thyroid orbitopathy (OT). Dry eye symptoms and clinical tests: break-up time (BUT), Schirmer I, fluorescein and lissamine green staining in OT patients, were comparable with control group. Dry eye symptoms were present in 85% of OT patients compared with 30% in control group. BUT (5.84 +/- 3,31sec.) and Schirmer test (11.11 +/- 9,14mm) were significantly lower when compared with control group (11.4 +/- 3,75sec and 20.5 +/- 9,65mm). Lissamin green staining intensity score (3.61 +/- 1,74) as well as positive fluorescein staining in OT patients, were significantly higher when compared with control.

Acromegaly is frequently associated with impaired glucose tolerance or diabetes. Insulin resistance has been reported to be related to low levels of adiponectin, which is exclusively produced by adipose tissue, as well as to decreased concentration of sex hormone binding globuline (SHBG). Growth hormone (GH) excess is associated with increased muscle mass and decreased fat mass. Influence of GH on production and secretion of adiponectin is not completely understood. The aims of this study were to assess serum adiponectin levels in patients with active acromegaly and to compare them with concentrations in the control group and to investigate relationships between adiponectin and indexes: body mass index (BMI) and waist-to-hip ratio (WHR) as well as SHBG levels.Serum adiponectin and SHBG levels were measured by radioimmunoassay in 30 patients with active acromegaly and in 22 sex-, age-, BMI- and WHR-matched controls. The groups were comparable in prevalence of hypertension and disturbances of glucose metabolism.Serum adiponectin concentrations were higher in acromegalic patients compared with control group (24.03 +/- 9.85 mg/ml vs. 14.46 +/- 3.96 mg/ml, p0.001). When the subjects were fallen into two groups according to sex, significant differences were also observed. Serum SHBG levels were lower in cases compared with controls (25.36 +/- 22.89 nmol/l vs. 33.54 +/- 15.07 nmol/l, p=0.03). In the control group we found adiponectin positively correlated with SHBG concentrations (r=0.53, p=0.01) and negatively correlated with BMI (r=-0.52, p=0.02) and WHR (r=-0.51, p=0.03). However, these relationships were not observed in patients with acromegaly. No significant associations were found between adiponectin and GH or IGF-I.Serum concentration of adiponectin is significantly higher in patients with acromegaly when compared with the control group and is independent of BMI, WHR and SHBG. The results suggest that adiponectinemia does not directly affect development of insulin resistance in acromegaly.

There is a lack of studies evaluating the prevalence of smoking habit among Polish priests. Due to difficulties in receiving permission from catholic authorities to perform questionnaire study we attempted to assess the prevalence of cigarette smoking among priests from one religious congregation. The aim of the study was also to analyze factors influencing smoking habits in this group. The anonymous questionnaire was sent to all Polish Pallotins and students of Pallotin Seminary in Ołtarzew. Only one fourth of them--138 subjects in the age from 20 to 92 yrs (mean age 37.7 yrs)--answered the questionnaire. Among them were 72 priests aged 27-92 yrs. (mean age 50.7 yrs) and 66 students in the age 20-41 yrs (mean age 23.7 yrs.). The rate of current smokers among priests was 13.9%, including 11.1% of daily smokers and 2.8% occasional smokers. The rates of daily and occasional smokers among Seminary students were 4.5% and 6.1%, respectively. Cigarette smoking in the past was reported by 26,4% of priests--8.3% of them had smoked daily, remaining subjects had smoked occasionally. Most of responders considered the fifth commandment of the Decalogue as sufficient reason for abstaining from cigarette smoking. The majority of current smokers attempted to stop smoking, mainly because of wholesome reasons. Near a half of smoking priests and over three fourth of smoking students felt embarrassed to smoke in company of laymen. Every tenth priest and every third student hide his smoking habit from other priests. The study showed low prevalence of cigarette smoking in priests, what resulted mainly from religious reasons.

The aim of the study was to evaluate association of apo E polymorphism with AMD.The included participants of this study were: 45 patients aged 60 to 71 (mean age 66.2 +/- 3.6), treated because of AMD. Genomic DNA was extracted from peripheral blood leukocytes, and the subsequent analysis of apo E genotypes was performed by polymerase chain reaction (PCR).In our study the allele frequencies in control group of patients weresimilar to the apo E allele distribution presented by other authors in Caucasian populations. We have not found significant differences between AMD and control group patients for apo (E) genotype or allele frequency. Compared with control group (epsilon4 -13.6%, epsilon2 -2.27%), the frequency of epsilon4 allele was not significantly decreased (11.11%) and epsilon2 allele frequency (7.77%) increased in AMD patients.The results of our present study have not indicate a significant association between AMD development and apo E allele frequency, in our studied population of AMD patients.

Little is known about the effects of menopause and hormone replacement therapy (HRT) on adiponectin production. The objectives of the study were to compare levels of serum adiponectin in post- and premenopausal women, to test whether adiponectin levels are related to endogenous estradiol and sex hormone-binding globulin (SHBG) levels, to determine whether HRT influences serum adiponectin, and to investigate relationships of adiponectin levels with cardiovascular risk factors. One hundred four women matched for body mass index were enrolled in this study, and among them were 34 postmenopausal HRT nonusers, 34 postmenopausal HRT users, and 36 premenopausal healthy women with regular menstrual cycles. We evaluated waist circumference and waist-to-hip ratio (WHR) in each women. Serum was assayed for adiponectin, estradiol, SHBG, triglycerides (TGs), total cholesterol, high-density lipoprotein cholesterol, and fasting glucose levels. Post- and premenopausal women showed no significant differences in adiponectin and SHBG concentrations. There were no differences in serum adiponectin levels between postmenopusal HRT nonusers and users; however, SHBG concentrations were higher in HRT users. The simple linear regression analyses of all studied women indicated that serum adiponectin was negatively correlated with body mass index, waist circumference, WHR, and TG levels. Positive correlation was observed between adiponectin and high-density lipoprotein cholesterol as well as between adiponectin and SHBG levels. There were no relationships between adiponectin and estradiol levels in all studied women and among subgroups. Multiple regression analysis showed that WHR and TG were significant independent predictors of serum adiponectin. In conclusion, serum adiponectin levels are not influenced by menopausal status or serum estradiol levels. Exogenous estrogen treatment does not significantly affect serum adiponectin concentrations.

A case of Wegener's granulomatosis in female aged 47 is described. Otological symptoms and signs connected with middle ear inflammation and masked mastoiditis about two months outstriped other signs particular from lower respiratory tract. The patient was surgically treated--antromastoidectomy was performed. After few days rapid worsening of patient's general state followed with hectic fever and inflammatory pulmonary changes. The patient was next treated in the Clinic of Pulmonary Diseases and Tuberculosis where the diagnosis of Wegener's granulomatosis was established on the basis of immunological findings (antibodies c-ANCA and PR3). The patient is treated from 9 months with cyclophosphamide and prednisone with improvement. The inability of ENT-surgeon in proper diagnosis and treatment in initial stage of the disease is stressed.

Age-related macular degeneration (AMD) is one of the leading causes of visual loss among people aged 65 and older. At present the origin of AMD still remains unknown. The objective was to evaluate the chosen lipid and lipoprotein concentrations in blood of patients with AMD. Sixty women aged 55-71 (mean age 65.1+/-5.7) were treated in the outpatient ophthalmological clinic for more than two years because of AMD. We evaluated total serum cholesterol (TCH), triglycerides (TG), HDL-cholesterol (HDL), LDL-cholesterol (LDL), lipoprotein (a) (Lp(a)), apolipoprotein AI (Apo AI) and apolipoprotein B (Apo B) by direct spectrophotometry (Human and Randox standard kits, USA). We found a significant increase of TCH, LDL and TG (224.36+/-41.67 mg/dl, 159.02+/-39.66 mg/dl and 120.92+/-42.64 mg/dl), and a significant decrease of HDL (38.68+/-6.36 mg/dl) in the AMD patients when compared with the control group. We have not found a significant difference in the average TG level between the studied groups. The concentration of Apo B was markedly increased (164.66+/-46.46 mg/dl) and Apo AI concentration was markedly decreased (128.9+/-17.01 mg/dl) in the AMD patients when compared with the control group. There was no significant difference in the concentration of the Lp(a) between the two groups. The results of our present study could point to the fact that changes in the lipid metabolism could be one of the very important risk factors involved in the pathogenesis of AMD.

The role of testosterone in the pathogenesis of atherosclerotic changes has not been fully explained. The aim of our work was to determine whether levels of serum free testosterone differ between men with and without coronary artery disease.We examined the serum concentration of free testosterone by the radioimmunoassay method in two groups of subjects, carefully matched for body mass index and age: 105 men with angiographically diagnosed coronary artery disease, and 23 control subjects without any changes in coronary arteries. We also evaluated the concentrations of total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides by enzymatic methods.Men with coronary artery disease had significantly lower levels of free testosterone than did controls. The concentration of free testosterone diminished with age, and a negative correlation was found between free testosterone and body mass index. We did not discover any connection between the concentration of free testosterone and lipids.A low level of free testosterone may be related to the development of coronary artery disease.

Osteocalcin is the most important noncollagenous protein component of the bone. Polymorphisms of osteocalcin gene were reported to be associated with bone mineral density. However, this relation was only confirmed in some populations. In this study presence of C/T polymorphism in osteocalcin gene (rs1800247) was determined in Kashubian population (northern Poland). The frequencies of variants were CC 9 %, TC 31 %, and TT 60 %, with no significant differences between genders. The genotypes were in Hardy–Weinberg equilibrium.

The pathogenesis of sarcoidosis remains still unknown. Among numerous factors viruses are considered as potential causes. The aim of the study was investigation of human T-cell lymphotopic virus type I (HTLV-I) in sarcoidosis patients. Studied group (I) consisted of 52 patients: 29 women and 23 men aged from 24 to 62 years; mean age 40 years. The diagnosis of sarcoidosis was confirmed by histologic examination in 46 patients and on the base of clinical, HRCT--chest scan and BAL findings in 6 patients. Control group (II) consisted of 92 various pulmonary disorders patients and healthy subjects in the aged from 20 to 83 years; mean age 54 years. In both groups the ELISA test detecting antibodies against HTLV-I/II was performed with the use the diagnostic kit produced by Organon Teknika, Belgium. Results were interpreted by measuring the optical density (OD). The cut-off point 0.386 was established according to the rule defined by kit's producent. The values of OD ranged in group I from 0.061 to 0.384 and in group II from 0.047 to 0.213; thus, no positive results of the test were observed. The values of OD did not differ significantly in both groups (p = 0.59).In our region the participation of HTLV-I in the pathogenesis of sarcoidosis is doubtful.

The aim of this work was to characterize the knowledge that patients have of their disease. A special questionnaire was distributed (in 1998) to 33 patients with ischemic cerebrovascular disease who underwent carotid endarterectomy (CEA) in 1995–1996. The results show that the knowledge of patients is fragmentary, hermetic, and static, at the same time serving as their basic perceptive–cognitive filter.

148 patients with cholecystolithiasis and 77 patients with functional dyspepsia were examined to isolate symptoms or a syndrome characteristic of 'pure' (i.e. uncomplicated and without any co-existing diseases) cholecystolithiasis and functional dyspepsia; to evaluate their specificity and sensitivity as well as to estimate the power of each symptom or a group of symptoms to differentiate both these conditions. Endoscopy, ultrasound scan and biochemical tests were performed in each patient to exclude co-existence of any other gastrointestinal disorders. Also irritable bowel syndrome was excluded according to Manning's criteria. It was found that both these conditions have most often seven co-existing dyspeptic symptoms and that each symptom separately has low sensitivity and specificity for cholecystolithiasis as well as functional dyspepsia. The diagnostic power of each symptom is weak and even summing them up into groups of symptoms does not increase their diagnostic power.

Objectives: Assessment of mean 24 h oestradiol (E2) and oestrone (E1) concentration and basic FSH secretion in postmenopausal asthmatic women, before and after HRT use, and to identify any connections between changes in hormone concentrations and patients’ clinical state. Subjects: Postmenopausal women (55 asthmatic and 20 healthy, aged 48–60 years). Method: Serum hormone concentration was assessed by radioimmunoassay before HRT and after 6 months of transdermal 17β-E2 and medroxyprogesterone acetate treatment (cyclical method). Intensification of menopausal symptoms was assessed by Kupperman’s index. Results: Secretion of oestrogens was lower in postmenopausal women asthmatic women than in postmenopausal healthy women. HRT caused an increase in oestrogen concentration. The 24-h fluctuations of E1 and E2 in all studied groups before and after HRT did not differ significantly. A statistically significant decrease in the number of menopausal symptoms was found during the course of HRT. During the period of HRT, there was a reduction in the number of patients in whom it was necessary to use oral glucocorticoid therapy during exacerbation of asthma. Conclusion: A greater reduction in oestrogen secretion was found in postmenopausal asthmatic women than in postmenopausal healthy women. HRT resulted in normalization of serum oestrogen concentration in asthmatic women and diminishing psychosomatic symptoms of the menopause and symptoms of asthma.

In some cases it is difficult to define an etiology of lung tumour in the other way than thoracotomy. In these diagnostic difficulties patients with tuberculous tumour are also involved. The aim of the present study was to define if A60-ELISA test, a new valuable tool in the diagnosis of tuberculosis, might be useful in the differential diagnosing of lung tumours. The levels of IgG antibodies against A60 antigen of mycobacteria was measured with the use of the ELISA test. 228 persons were enrolled into the study: 58 healthy controls (Group I), 26 nonmalignant and nontuberculous patients (Group II), 56 patients with the diagnosis of pulmonary tuberculosis bacteriologically confirmed (Group III), 54 pulmonary tuberculosis patients culture negative (Group IV), 16 patients with lung tumour, without histologic diagnosis before thoracotomy (Group V) and 18 patients with defined diagnosis of lung cancer (Group VI). By using 200 U/ml as a cut-off point the test was positive in: 2/58 subjects from Group I, 2/26 from Group II, 44/56 from Group III, 31/54 from Group IV, 3/16 from Group V and 0/18 from Group VI. In three patients from group V having positive result of A60-ELISA test pulmonary tuberculosis was diagnosed when the thoracotomy was performed. We conclude that the new, simple, noninvasive and inexpensive A60-ELISA test migt be the useful tool in the differential diagnosing of lung tumours because of its good sensitivity and specificity in pulmonary tuberculosis. We also consider that in lung tumour patients with the positive result of this test the prophylactic antituberculosis treatment have to be ordered before planned thoracotomy.