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The purpose of the study was to assess the usefulness of optical coherence tomography (OCT) in the detection of the neurodegenerative process in younger patients with multiple sclerosis (MS). The study group consisted of 61 patients with a relapsing remitting course of MS (mean age 36.4 ± 6.7 years) divided into two groups: short (≤5 years) and long (>10 years) disease duration. OCT, P300 evoked potential, Montreal Cognitive Assessment, and performance subtests (Picture Completion and Digit Symbol) of the Wechsler Adult Intelligence Scale were performed in all patients. Mean values of most parameters assessed in OCT (pRNFL Total, pRNFL Inferior, pRNFL Superior, pRNFL Temporalis, mRNFL, GCIPL, mRNFL+GCIPL) were significantly lower in MS patients in comparison to controls. And in patients with longer disease duration in comparison to those with shorter. Most OCT parameters negatively correlated with the EDSS score (p < 0.05). No significant correlation was found between OCT results and both P300 latency and the results of psychometric tests. OCT, as a simple, non-invasive, quick, and inexpensive method, could be useful for monitoring the progression of disease in MS patients.

Szerokość dystrybucji krwinek czerwonych jest odzwierciedleniem rozkładu wielkości erytrocytów, a co za tym idzie – stanowi wiarygodny i miarodajny wskaźnik anizocytozy, powszechnie stosowany w diagnostyce różnicowej niedokrwistości mikro-, makro- oraz normocytarnej. Opierając się na najnowszych doniesieniach naukowych z ostatnich dekad, zaobserwowano, że zakres szerokości dystrybucji krwinek czerwonych w sposób istotny odzwierciedla pogarszające się rokowania oraz jest związany z obecnością powikłań u pacjentów cierpiących z powodu chorób sercowo-naczyniowych. Niniejszy artykuł ma na celu omówienie najważniejszych doniesień naukowych dotyczących korelacji szerokości dystrybucji krwinek czerwonych z incydentami sercowo-naczyniowymi oraz ze śmiertelnością w celu oceny jego przydatności jako taniego i łatwo dostępnego markera w praktyce klinicznej. Posiłkując się dostępnymi danymi, uzasadnione wydaje się twierdzenie, że nieprawidłowe szerokości dystrybucji krwinek czerwonych powinny skłaniać do dalszego poszerzania diagnostyki niedokrwistości oraz chorób sercowo-naczyniowych.

Background: Over the past few years, an increase in the incidence of eating disorders has been noted. An increase in the pace of life, an increase in the availability of a wide variety of food products, and, to a large extent, the involvement of mass media are cited as reasons for this phenomenon. The promotion of a slim figure by the mass media is equated with achieving success in life, but also the advertising of a wide selection of food products (often highly processed) can have a serious impact on the development of eating disorders. This phenomenon is particularly observed in industrialized Western countries. Objective: Therefore, it was decided to test and compare whether dietetics students are indeed more predisposed to developing eating disorders than students not in the nutrition field. Material and methods: the study included 310 individuals representing two equal groups of fields of study—dietetics and other students. The study used standardized questionnaire—EAT-26. Results: It was found that almost half (46%) of the respondents (both dietetics students and students of other majors) met at least one criterion out of three that could indicate the probable existence or susceptibility to an eating disorder. These individuals should see a specialist for further diagnosis. There was no significant effect of the field of study on the overall EAT-26 test score (p > 0.05). When this result was corrected for BMI values for those with the lowest scores on this indicator, the risk of eating disorders was found to be higher among students of majors other than dietetics (X2 = 13.572; V = 0.831 p = 0.001). Conclusions: Almost half of the respondents in both study groups showed a predisposition to eating disorders based on the EAT-26 test. Despite the presence of a correlation in individual responses that dietetics students are more predisposed to eating disorders, no such relationship was found according to the final EAT-26 test scores. However, it was observed that non-dietetics students who had low BMI values showed higher tendencies toward behaviors indicative of eating disorders.

OBJECTIVE The aim: To analyze the nutritional knowledge of women in the reproductive age about nutrients influencing the fetal nervous system's development. PATIENTS AND METHODS Materials and methods: The study was conducted with a proprietary anonymous questionnaire using the CAWI (Computer Assisted Web Interviews) method among 263 women aged 18-51 years. RESULTS Results: In 35.4% of the surveyed women, the level of knowledge was insufficient, in 31.9% - sufficient, in 27% - good, and only in 5.7% - very good. The knowledge of the respondents was influenced by education (p < 0.001) and body mass index (BMI, p < 0.001). Women of reproductive age with higher education and/or lower BMI had a better understanding of nutrients influencing the fetal nervous system's development. Age, place of residence, family status, and professional status did not affect their knowledge. CONCLUSION Conclusions: The study showed that it is necessary to conduct nutritional education among women of reproductive age. Increasing the respondents' awareness of the importance of nutrients determining the fetus's proper development, both during the reproductive period and during pregnancy, is extremely important.

Background and Aims: Body-mass index (BMI) is a popular method implemented to define weight status. However, describing obesity by BMI may result in inaccurate assessment of adiposity. The Body Adiposity Index (BAI) is intended to be a directly validated method of estimating body fat percentage. We set out to compare body weight status assessment by BMI and BAI in a cohort of elderly patients with stable coronary artery disease (CAD). Methods: A total of 169 patients with stable CAD were enrolled in an out-patient cardiology clinic. The National Research Council (US) Committee on Diet and Health classification was used for individuals older than 65 years as underweight BMI &lt, 24 kg/m2, normal weight BMI 24–29 kg/m2, overweight BMI 29–35 kg/m2, and obesity BMI &gt, 35 kg/m2. In case of BAI, we used sex- and age-specific classification of weight status. In addition, body fat was estimated by bioelectrical impedance analysis (BImpA). Results: Only 72 out of 169 patients (42.6%) had concordant classification of weight status by both BMI and BAI. The majority of the patients had their weight status either underestimated or overestimated. There were strong positive correlations between BMI and BImpA (FAT%) (R = 0.78 p &lt, 0.001), BAI and BImpA (FAT%) (R = 0.79 p &lt, and BMI and BAI (R = 0.67 p &lt, 0.001). BMI tended to overestimate the rate of underweight, normal weight or overweight, meanwhile underestimating the rate of obesity. Third, BMI exhibited an average positive bias of 14.4% compared to the reference method (BImpA), whereas BAI exhibited an average negative bias of −8.3% compared to the reference method (BImpA). Multivariate logistic regression identified independent predictors of discordance in assessing weight status by BMI and BAI: BImpA (FAT%) odds ratio (OR) 1.29, total body water (%) OR 1.61, fat mass index OR 2.62, and Controlling Nutritional Status (CONUT) score OR 1.25. Conclusions: There is substantial rate of misclassification of weight status between BMI and BAI. These findings have significant implications for clinical practice as the boundary between health and disease in malnutrition is crucial to accurately define criteria for intervention. Perhaps BMI cut-offs for classifying weight status in the elderly should be revisited.

The present study was designed to evaluate soluble receptors as potential targets for lead (Pb). Analyses included the serum levels of soluble Vascular Endothelial Growth Factor Receptors 2 (sVEGFR-2), soluble Epidermal Growth Factor Receptor (sEGFR), soluble Human Epidermal Growth Factor 2 (sHER-2/neu), and soluble Interleukin 6 Receptors (sIL-6R) in the groups of chronically and subchronically occupationally exposed workers. The first group consisted of 56 male workers chronically exposed to Pb. The second group (control) comprised 24 male administrative workers. The third group included 36 male workers exposed to Pb for 40 ± 3 days. Examined subjects were employed in the Pb–zinc works to perform periodic maintenance of blast furnaces and production lines. The serum levels of sHER-2/neu and sIL-6R were significantly lower in the group of workers chronically exposed to Pb compared to control values by 45% ( p < 0.05) and 44% ( p < 0.05), respectively. The values of sVEGFR-2 and sEGFR decreased after a subchronic exposure to Pb compared to baseline by 14% ( p < 0.05) and 21% ( p < 0.05), respectively. At the same time, the levels of sIL-6R also decreased by 14% ( p < 0.05). Results of the present study indicated that both chronic and subchronic occupational Pb exposures resulted in decreased levels of several soluble receptors (sVEGFR-2, sEGFR, sHER-2/neu, and sIL-6R), probably due to Pb-induced modulations of the transcription factors and metalloprotease activities, that are necessary for soluble receptor synthesis.

There is little published data on the association of platelet function and 25(OH)D concentration. We investigated the associations between mean platelet volume (MPV) and 25(OH)D concentration in patients with stable coronary artery disease. Study population was divided into three groups: group 1—25(OH)D 20 ng/mL (N = 14). Study groups shared similar demographics. MPV values were the highest in group 1, moderate in group 2, and the lowest in group 3 (11.1 vs 10.4 vs 9.8 fL P 10.5 fL) for vitamin D deficiency and a weak predictive value (AUC 0.65) in identifying the discrimination thresholds of 25(OH)D concentration (≤ 15.5 ng/mL) for the presence of large platelets (MPV over the upper limit of normal). In conclusion, even though the effect of vitamin D on platelet size and function is probably multifactorial, our study provides further evidence linking vitamin D to thrombosis and hemostasis. Platelets are another potential element through which vitamin D deficiency could exert adverse cardiovascular outcomes.

Aims Diabetes mellitus (DM) is one of the most frequently detected conditions in multimorbid disease clusters. Platelet activation is one of the key mechanisms underlying atherothrombosis in acute myocardial infarction. Available data link mean platelet volume (MPV) to poor prognosis not only in cardiovascular and non-cardiovascular disease. Given the lack of research data on the association between disease clusters and MPV, we have set out to investigate the link between multimorbidity and MPV in diabetic patients with acute myocardial infarction. Methods A total of 277 patients with DM and STEMI undergoing primary percutaneous coronary intervention were enrolled. Based on the number of comorbidities the study population was divided into two groups: group 1 (N = 58) with ≤ 1 comorbidity and group 2 (N = 219) with ≥ 2 comorbidities. A subanalysis was performed within the multimorbidity group: group 2A with two or three comorbidities (N = 156) and group 2B with at least four comorbidities (N = 63). Results In the study population, 15.9% of patients had one comorbidity, and 22.0, 34.3, and 22.7% of patients had two, three, or at least four comorbid conditions, respectively. Both MPV and PDW were elevated in multimorbid patients (9.3 vs 10.8 fl and 9.5 vs 10.3 fl, respectively). The highest platelet volume indices were observed in patients with at least four comorbid conditions. There was a moderate positive correlation between MPV and the total number of comorbidities, the number of CVD comorbidities, and the number of non-CVD comorbidities. Conclusions These findings indicate that multimorbidity is associated with an increase in platelet volume indices. MPV values increased with the increasing number of comorbid conditions. Importantly, MPV values were elevated in some, but not all CVD and non-CVD conditions.

// Bartosz Hudzik 1, 2 , Ilona Korzonek-Szlacheta 2 , Janusz Szkodzinski 1 , Marek Gierlotka 1 , Andrzej Lekston 1 , Barbara Zubelewicz-Szkodzinska 2 and Mariusz Gąsior 1 1 Third Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Disease, Zabrze, Poland 2 Department of Nutrition-Related Disease Prevention, School of Public Health in Bytom, Medical University of Silesia in Katowice, Katowice, Poland Correspondence to: Bartosz Hudzik, email: bartekh@mp.pl Keywords: myocardial infarction; diabetes mellitus; comorbidity; multimorbidity; prognosis Received: May 30, 2017 Accepted: September 13, 2017 Published: November 06, 2017 ABSTRACT Introduction: There is an increasing body of evidence on the clinical importance of multimorbidity, which is defined as the coexistence of two or more chronic conditions. Type 2 diabetes (T2DM) is one of the most frequent chronic conditions. Most adults with type 2 diabetes have at least 1 coexisting chronic condition and approximately 40% have 3 or more. Prior studies have suggested that cardiovascular (CVD) and non-CVD comorbid conditions yield worse outcomes in patients hospitalized with ST-elevation myocardial infarction (STEMI). It is unclear, however, the extent to which multimorbidity has a cumulative effect on long-term risk. Therefore we have set out to determine the prognostic value of multiple comorbidity on long-term outcomes in this population of patients. Methods: A total of 277 patients with T2DM and STEMI undergoing primary percutaneous coronary intervention (PCI) were enrolled. Based on the number of comorbidities the study population was divided into two groups: group 1 (N=58) with ≤ 1 comorbidity and group 2 (N=219) with ≥ 2 comorbidities. Results: Comorbid conditions were prevalent among study participants ( Figure 1 ). The median number of comorbidities was three. 15.9% of patients had one comorbidity and 22.0%, 34.3%, and 22.7% of patients had two, three or at least four comorbid conditions respectively. A majority of patients had at least one CVD comorbidity (6.1% of patients had none), whereas 53.1% of patients did not have any non-CVD comorbidity. During hospitalization 3 out of 58 patients (5.2%) died in group 1 and 25 of 219 patients (11.4%) died in group 2. The number of comorbid conditions was not an independent predictor of in-hospital death. During 12-month follow-up, 5 of 58 patients (8.6%) and 42 of 219 patients (19.9%) died, respectively in group 1 and 2 (P=0.05). The number of comorbid conditions proved in ROC analysis that for 12-month mortality, the prognostic value was modest, but for 12-month acute coronary syndromes the prognostic value was good. Increase in the number of comorbid conditions by one was associated with a 15% increase in the relative risk of 12-month mortality and a 41% increase in the relative risk of 12-month acute coronary syndromes (ACS). Conclusions: Comorbid conditions are highly prevalent among these groups of patients. Majority of patients have at least 2 other cardiovascular comorbidities and one or two non-cardiovascular comorbidities. In terms of long-term follow-up, multimorbidity was associated with worse outcomes. The risk of both long-term mortality and ACS increased with the increasing number of comorbidities. In summary, our findings highlight the importance of indentifying patients with multimorbidity. This, in turn, could allow for provision of better care to these high-risk and complex group of patients.

Few reports have analyzed the effect of pentraxin 3 (PTX3) on platelets and their activation. We explored the association between plasma PTX3 and platelet indices. Forty-nine patients with stable coronary artery disease (CAD) were enrolled. Based on median PTX3, the study population was divided into group 1 (n = 25; PTX3 ≤ 0.98 ng/mL) and group 2 (n = 24; PTX3 > 0.98 ng/mL). Platelet indices investigated included mean platelet volume (MPV), platelet distribution width (PDW), platelets and large cell ratio (P-LCR), MPV to platelet count ratio (MPV/PC), platelet to lymphocyte ratio (PLR), and MPV to lymphocyte ratio (MPVLR). Patients with lower PTX3 had a higher lymphocyte count. Platelet count was similar in both groups. Notwithstanding, patients with higher PTX3 concentrations had elevated MPV (8.3 vs 10.0 fL; P < .001) and PDW (9.4 vs 12.4 fL; P < .001). However, the MPV/PC ratio was similar in both groups. Thromboinflammatory biomarkers (PLR, MPVLR) were also elevated in group 2. Pentraxin 3showed a strong, positive correlation with MPV ( r = .75, P < .01) and PDW ( r = .80, P < .01), and weak to moderate correlation with MPVLR. In conclusion, PTX3 is associated with larger platelet size as assessed by platelet volume indices. There is a strong correlation between plasma PTX3 level and MPV and PDW.

Trimetazidine (TMZ) exhibits metabolic and cardioprotective effects. The aim of this study was to assess the effects of TMZ on interleukin-2 (IL-2) and interleukin-8 (IL-8) serum concentrations in 156 patients with stable coronary artery disease. They underwent a treadmill exercise test (TET) before and after 3 months of TMZ treatment. IL-2 and IL-8 concentrations were determined before and after each TET. Before treatment, TET did not influence IL-2 concentrations, whereas IL-8 concentrations increased. TMZ treatment led to a decrease in IL-2 concentrations before TET, as well as it prevented the increase of IL-8 following the second TET. Obtained results confirmed the improvement in TET performance during TMZ treatment and they revealed a significant influence of TMZ on IL-2 and IL-8 concentrations both before and after TET. These changes may reflect potential anti-inflammatory effects of TMZ.

Cardiovascular diseases remain the leading cause of death in Poland and other countries of the European Union. Patients with end-stage heart failure constitute a patient subgroup for whom the treatment of choice is heart transplantation. Despite advances in immunosuppressive therapy, acute or chronic graft rejection occurs in 20-30% of cases in the first six months after transplantation. The significance of the immune response and inflammation in graft rejection implies the important role of cytokines. Molecular markers are sought to facilitate risk assessment and improve patient care. At present, genetic tests are not used for this purpose, but studies aiming to rectify that have been conducted for years, including studies on single nucleotide polymorphisms of cytokine genes. This paper presents the results of research on the single nucleotide polymorphisms (SNPs) of the IL-2, IL-4, IL-6, IL-10, TGF-β1, PDGF, VEGF, and TNF-α genes in conjunction with heart transplantation. The analyzed data do not allow for reliable application of these genetic tests in clinical practice, but suggest that it is a promising direction which may improve the options of treatment individualization in the future.

Aim: There has been a rise in contrast-induced acute kidney injury (CI-AKI). We examined the role of platelet-to-lymphocyte ratio (PLR) in predicting CI-AKI episodes in patients with myocardial infarction (MI) and diabetes. Methods: A total of 719 patients with diabetes and MI were enrolled. Study population was divided into: group 1 (n = 615) without CI-AKI and group 2 (n = 104) with CI-AKI. Results: Patients with CI-AKI had higher in-hospital mortality and a longer in-hospital stay. Median PLR was higher in patients with CI-AKI. Receiver operating characteristic analysis indicated PLR to be a good predictive tool in assessing the risk of CI-AKI. PLR was an independent predictor of CI-AKI (OR: 1.22; p

Chalcones belong to the flavonoids family and are natural compounds present in edible plants. The term chalcone was coined by Stanislaw Kostanecki and Josef Tambor. Chalcones exhibit a broad spectrum of biological activity and thus have attracted more and more attention due to their anticancer and chemopreventive effects. Chemoprevention is one of the most promising approaches for arresting many types of cancer cells or reversing the process of carcinogenesis. Preclinical and epidemiological studies have shown that chalcones can inhibit cancerogenesis at very early stages. The tumor necrosis factor–related apoptosis-inducing ligand (TRAIL) is a protein that exists in soluble form or is expressed on the surface of immune effector cells. This ligand induces apoptosis in cancer cells while showing no toxicity for normal cells. Some cancer cells, however, are resistant to TRAIL-mediated cell death through a many survival mechanisms. Chalcones in combination with TRAIL can sensitize TRAIL-resistant cancer cells to apoptosis through different mechanisms in apoptotic pathway.

Expression level of Tumor Necrosis Factor—related apoptosis—inducing ligand (TRAIL) receptors is one of the most important factors of TRAIL-mediated apoptosis in cancer cells. We here report for the first time data concerning TRAIL-R1 and TRAIL-R2 receptor expression on RAW264.7 macrophages. Three substances belonging to flavones: chrysin, apigenin and acacetin which differ from their substituents at the 4' position in the phenyl ring were used in assays because of the variety of biological activities (e.g., anticancer activity) of the polyphenol compounds. The expression of TRAIL-R1 and TRAIL-R2 death receptors on non-stimulated and LPS (lipopolysaccharide)-stimulated macrophages was determined using flow cytometry. We demonstrate that RAW264.7 macrophages exhibit TRAIL-R1 surface expression and that the tested compounds: chrysin, apigenin and acacetin can inhibit TRAIL-R1 death receptor expression level on macrophages.

The study was undertaken to determine blood serum concentrations of selected steroid hormones (estradiol--E(2), testosterone--T, dehydroepiandrosterone sulfate--DHEA-S) and luteinizing hormone (LH) in professional footballers subjected to whole body cryotherapy.Twenty-two clinically healthy males, mean age 26.7 years, were studied. The subjects underwent ten sessions of whole body cryotherapy in Wroclaw-type chamber, with kinesitherapy following each session. Blood samples were collected before and two days after the treatment and the results were analyzed statistically.After the treatment there was a significant decrease in the concentrations of T (6.01 vs. 4.80 ng/mL, p0.01) and E(2) (102.3 vs. 47.5 pg/mL, p0.00001), but no DHEA-S and LH. The T/E(2) ratio showed a significant increase form 72.2 to 136.5 (p0.01).Whole body cryotherapy leads to a significant decrease in serum T and E(2), with no effect on LH and DHEAS levels. As a results of cryotherapy, the T/E(2) ratio was significant increased. The changes observed are probably due to cryotherapy-induced alternation in the blood supply to the skin and subcutaneous tissue, as well as to modulation of the activity of aromatase which is responsible for conversion of testosterone and androstenedione to estrogens.

The aim of this study was to examine the effects of posthemorrhagic hypovolemia and hypotension upon the microvascular endothelial cells and on activity of antioxidant enzymes in blood, and to investigate the influence of intravenously injected endothelin-1 in rats. The experiment was conducted on 48 rats anesthetized with ethylurethane, subjected to controlled hypotension (under 35-40 mmHg) for 60 min. Endothelin-1 was administered intravenously once at a dose of 50 pmol/kg in the 5th min of hemorrhagic shock. The control group had blood volume restored after 5 min of hypovolemia with hypotension. The arterial blood pressure, systolic and diastolic, and heart rate were monitored. After 60 min, morphological changes in the capillary endothelium of the small intestine were assessed, using electron microscope, and the activities of superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-PX) in blood were measured. Animals with hypovolemia and hypotension, had edematous endothelial cells with injured cell-membrane and mitochondria, alongside of the enhancement in SOD activity (p0.05) and drop in the activity of CAT and GSH-PX. No signs of vascular endothelium injuries and no reduced enzymatic activities, except for GSH-PX, were observed after restoring the normal blood pressure by means of endothelin-1 in animals with hypovolemia. Hemorrhagic shock caused injuries in intestinal microcascular endothelium. Intravenously administered endothelin-1 quickly restored normal blood pressure, maintained it over a long time, and prevented the consequences of ischemia in microcirculation, thereby prolonging the survival for animals in hemorrhagic shock.