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Obesity in adults and its complications are among the most important problems of public health. The search was conducted by using PubMed/MEDLINE, Cochrane Library, Science Direct, MEDLINE, and EBSCO databases from January 2010 to December 2022 for English language meta-analyses, systematic reviews, randomized clinical trials, and observational studies from all over the world. Six main topics were defined in the joint consensus statement of the Polish Association for the Study on Obesity, the Polish Association of Endocrinology, the Polish Association of Cardio-diabetology, the Polish Psychiatric Association, the Section of Metabolic and Bariatric Surgery of the Society of Polish Surgeons, and the College of Family Physicians in Poland: (1) the definition, causes and diagnosis of obesity; (2) treatment of obesity; (3) treatment of main complications of obesity; (4) bariatric surgery and its limitations; (5) the role of primary care in diagnostics and treatment of obesity and barriers; and (6) recommendations for general practitioners, regional authorities and the Ministry of Health. This statement outlines the role of an individual and the adequate approach to the treatment of obesity: overcoming obstacles in the treatment of obesity by primary health care. The approach to the treatment of obesity in patients with its most common complications is also discussed. Attention was drawn to the importance of interdisciplinary cooperation and considering the needs of patients in increasing the long-term effectiveness of obesity management.

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Background The consumption of breakfast, salty meals, red meat, whole grain products, and dark chocolate are dietary habits that influence health, but the effects on arterial stiffness have not been well-investigated. Aim. To assess the effects of selected dietary patterns on arterial stiffness, liver and renal function, inflammation, and glucose and lipid biochemical parameters. Methods 829 patients completed health and food frequency questionnaires, and underwent anthropometric, arterial stiffness, and blood pressure measurements. Serum concentrations of lipids, glucose, alanine and aspartate aminotransferases, creatinine, uric acid, and C-reactive protein were determined. Results The aspartate aminotransferase serum concentration was lower in the breakfast-consuming group (25.88 ±7.05 U/L) compared to non-consumers (27.75 ±10.67 U/L). A lower concentration of creatinine and alanine aminotransferase and a higher concentration of C-reactive protein was found in whole grain product consumers. Individuals consuming more red meat had higher alanine aminotransferase and low-density lipoprotein serum concentrations. Individuals with greater dark chocolate consumption had higher serum concentrations of uric acid (5.20 ±1.46 vs. 4.72 ±1.18) and more intensified arterial stiffness (peak-to-peak time 213.86 ±54.98 ms vs. 238.70 ±60.83 ms). Conclusions The investigated dietary patterns had a significant impact on serum lipid concentrations, biochemical markers of liver and renal function and inflammation, and arterial stiffness. High consumption of red meat and dark chocolate intensified cardiovascular risk, contrary to the intake of whole grain products.

Background: Resistin action links to conditions such as diabetes, obesity, but its role in hypertension is less well understood. This study aimed to estimate the relationship between resistin (−420G/C) single nucleotide variant (SNV) and markers associated with endothelial dysfunction in hypertension. Methods: The study enrolled 162 hypertensive patients (HT) and 165 non-hypertensive (NHT) patients. Resistin serum concentration was estimated with immuoenzymatic assay. Anthropometric measurements, blood pressure and arterial stiffness index (SI), uric acid (UA) serum concentration, and salty taste preference of normal (NS) or high (HS) were assessed in the study. Genotyping was achieved by polymerase chain reaction-restriction fragment length polymorphism. Results: Resistin concentration and SI do not differ significantly between HT and NHT individuals; UA significantly increased in HT subjects. Resistin, UA, and SI did not differ among particular resistin genotypes in HT, NHT, NS, or HS groups. GG and CG genotypes were more frequent (OR 1.57 (95% CI; 1.01–2.43); p = 0.04) in hypertensive individuals than the NHT group, but less frequent (OR 0.58 (95% CI; 0.37–0.91); p = 0.01) in HS patients compared to NS individuals. Concerning HT patients with different salt preferences, GG + CG genotypes were less frequent (OR 0.50 (95% CI; 0.26–0.97); p = 0.04) in the HS group than in NS individuals. HT carriers of GG and CG genotype have significantly increased UA concentrations compared to the respective NHT subjects. HS individuals carrying GG and CG genotypes have higher SI values than the NS group. Allele G of SNV (−420G/C) adjusted for age, BMI, serum resistin, UA concentration, salt taste preference, SI, and HR values increased the risk of developing hypertensive phenotype 1.8 fold. Conclusions: Resistin SNV (−420G/C) is related to several markers associated with endothelial dysfunction, including salt taste preference in hypertensive patients.

One of the consequences of polycystic ovary syndrome (PCOS) is an increased risk of early development of cardiovascular diseases. Pentraxin-3 (PTX-3) is a new potential marker of endothelial dysfunction. The aim of the study was to assess PTX3 and other markers of endothelial dysfunction in PCOS women. The study enrolled 99 stable body mass PCOS women (17 normal weight, 21 overweight and 61 obese). Anthropometric measurements and serum/plasma levels of glucose, insulin, lipids, estradiol, testosterone, sex hormone binding globulin, 17-OH progesterone, free androgen index, pentraxin-3 (PTX3), soluble intercellular (sICAM-1) and vascular cell adhesion molecule 1 (sVCAM-1), endothelin-1 and total nitric oxide metabolites (tNO) concentrations were assessed. Groups were divided into tercile-subgroups according to PTX3 serum levels. Serum PTX3 tercile-subgroups significantly differed in respect to tNO, endothelin-1 and sVCAM-1, but not sICAM-1. The levels of tNO, endothelin-1 and sVCAM-1 were significantly decreased in the subgroup with the lowest PTX3 levels compared to both middle (tNO and endothelin 1) and upper tercile subgroups (all of them). There were significant positive correlations between log

Fluctuations in biochemical parameters defining cardiovascular, liver and muscoskeletal health were analyzed to evaluate the health status of world class bodybuilders using performance enhancement drugs such as anabolic-androgenic steroids (AAS) [testosterone propionate, drostanolone propionate (Masteron), trenbolone acetate (Finajet), oxandrolone (Anavar), stanozolol (Winstrol) and boldenone undecylenate], human growth hormone (HGH) and “fat-burning drugs” [triiodothyronine (t3), clenbuterol, mesterolone (Proviron), tamoxifen citrate (Nolvadex) and 2,4-Dinitrophenol (2,4-DNP)], and a 6-month preparation period. Changes in serum levels of total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL-C), low-density lipoprotein (LDL-C), aspartate aminotransferase (AST), alanine transaminase (ALT), and bilirubin, as well as body mass (BM) and total body fat percentage (BF%), were measured as a function of the competition preparation period. The study shows a continuous increase in BM, accompanied by a decrease in BF% to the physiologically optimal level. TC levels varied significantly within the desired concentration range (TC < 5.18 mmol / L), and TG fluctuated between the ranges of concentrations borderline high (1.69 mmol / L ≤ TG < 2.26 mmol / L) and high (2.26 mmol / L ≤ TG < 5.65 mmol / L) concentration ranges. HDL-C levels remained within the low range (TG < 1.03 mmol / L), whereas LDL-C fluctuated across all physiologically important ranges, that is, near-optimal / above optimal (2.59 mmol / L ≤ LDL-C < 3.34 mmol / L), borderline high (3.35 mmol / L ≤ LDL-C < 4.11 mmol / L), and high (4.14 mmol / L ≤ LDL-C < 4.91 mmol / L). AST and ALT concentrations remained within the high-concentration region, i.e., > 0.58 mkat / L and > 0.91 mkat / L. Bilirubin concentration fluctuated within the desirable limits (3.42 mmol / L ≤ Bilirubin < 2.53 mmol / L), and urea concentration were between desirable (3.2 mmol / L ≤ Urea < 7.9 mmol / L) and high values (Urea ≥ 7.9 mmol / L). Although most of the changes are within physiologically acceptable ranges, there are evident disturbances in LDL-C and Urea levels induced by performance-enhancing drugs. To our knowledge, this study is among the few, if not the only, that discloses the physiological changes associated with doping-assisted preparations for an international bodybuilding contest.

Objective. The aim of the study was to assess PTX3 levels in PCOS and non-PCOS women in relation to nutritional status and circulating markers of inflammation.Methods. The study enrolled 99 stable body mass PCOS women (17 normal weight, 21 overweight, and 61 obese) and 61 non-PCOS women (24 normal weight, 19 overweight, and 18 obese). Body composition was assessed by bioimpedance, and plasma levels of pentraxin 3 (PTX3), tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6), and monocyte chemoattractant protein 1 (MCP-1) were measured. Homeostatic model assessment of insulin resistance (HOMA-IR) was made.Results. Plasma PTX3, TNF-α, and IL-6 levels and HOMA-IR were higher in PCOS than in non-PCOS groupp<0.001. There were positive correlations between log10(PTX3) and log10(BMI), waist circumference and fat percentage, as well as log10(HOMA-IR) and free androgen index but negative between log10(estradiol) levels in PCOS. While in the non-PCOS group, the correlations between log10(PTX3) and log10(BMI), waist circumference and fat percentage, as well as log10(HOMA-IR) were negative. The positive correlations between PTX3 and MPC-1 and log10(IL-6) were shown in the PCOS group only. In multivariate regression analyses, variability in PTX3 levels in the PCOS group was proportional to log10(BMI), waist circumference, and fat percentage, but inversely proportional to log10(estradiol) levels. While in the non-PCOS group, PTX3 levels were inversely proportional to all anthropometric parameters.Conclusions. Our results show that the decrease in PTX3 levels observed in obese is distorted in PCOS by microinflammation, and possibly, dysfunction of stroma adipose tissue and liver steatosis is reflected by enhanced insulin resistance.

Wstep : Nadmierne wytwarzanie reaktywnych postaci tlenu (ROS), zwane stresem oksydacyjnym, wiąze sie z niewydolnością enzymatycznych ukladow antyoksydacyjnych (katalaza, peroksydaza glutationowa, dysmutaza ponadtlenkowa), a takze z niedoborem nieenzymatycznych antyutleniaczy, do ktorych nalezy m.in. zredukowany glutation (GSH). Zjawisko stresu oksydacyjnego, w ktorym fagocyty są stymulowane do syntezy ROS zwiekszających uszkodzenie na poziomie tkankowym, odgrywa wazną role w niedokrwieniu i reperfuzji. Zespoly poreperfuzyjne (groźne zaburzenia rytmu, wlącznie z migotaniem komor, skurczowa niewydolnośc miokardium) stanowią aktualny problem kardiologii interwencyjnej. Celem pracy jest przedstawienie poglądow na temat patofizjologii procesu uszkodzenia poreperfuzyjnego i ogluszenia mieśnia sercowego oraz wskazania potencjalnych związkow chemicznych i miejsca ich dzialania, ktore mogą oslabic toksyczne uszkodzenie mieśnia po reperfuzji lub zapobiegac jego uszkodzeniu i skracac okres ogluszenia. Material i metody : Dokonano przeglądu publikacji polskich i zagranicznych dotyczących ogluszenia mieśnia sercowego, roli wolnych rodnikow tlenowych w uszkodzeniu poreperfuzyjnym i funkcjonowania ukladow antyoksydacyjnych w przebiegu zawalu i innych postaci choroby niedokrwiennej serca. Uwzgledniono zarowno badania kliniczne, jak i eksperymentalne. Wnioski : Mimo ze przeprowadzono wiele badan, nie znaleziono skutecznej metody leczenia urazow poreperfuzyjnych. Istnieje hipoteza (potwierdzona na modelu zwierzecym), ze podanie egzogennego GSH, ktory ma potencjal neutralizujący wolne rodniki tlenowe, moze ograniczyc uraz poreperfuzyjny w mieśniu sercowym i jego uszkodzenie prowadzące do niewydolności serca. Zredukowany glutation wydaje sie preparatem bezpiecznym, w piśmiennictwie nie ma danych o jego interakcjach. Wciąz jednak zbyt malo wiadomo na ten temat i potrzebne jest przeprowadzenie dalszych badan dotyczących zastosowania glutationu w prewencji ogluszenia mieśnia sercowego po reperfuzji.

Background: Antihypertensive drugs affect mineral metabolism, inflammation, and the oxidative state. The aim of this study was to evaluate the effects of antihypertensive monopharmacotherapy with diuretics, &beta, blockers, calcium antagonists (Ca-antagonists), angiotensin-converting enzyme inhibitors (ACE-I), and angiotensin II receptor antagonists (ARBs) on zinc (Zn), iron (Fe), and copper (Cu) status, parameters of oxidative and inflammatory states, and glucose and lipid metabolism in patients with newly diagnosed primary arterial hypertension (AH). Methods: Ninety-eight hypertensive subjects received diuretics, &beta, blockers, Ca-antagonists, ACE-I, or ARB for three months. Zn, Fe, and Cu concentrations were determined in blood, urine, and hair. Results: A decrease in zinc serum and erythrocyte concentration and an increase in zinc urine concentration were registered after diuretic administration. Ca-antagonists led to a decrease in erythrocyte zinc concentration. A decrease in serum zinc concentration was observed after ACE-I. A decrease in triglyceride serum concentration was noted after ACE-I therapy, and a decrease in tumor necrosis factor-&alpha, serum concentration was seen following administration of Ca-antagonists. Hypotensive drugs led to decreases in catalase and superoxide dismutase serum concentrations. Conclusions: Three-months of monotherapy with diuretics, Ca-antagonists, or ACE-I impairs zinc status in patients with newly diagnosed primary AH. Antihypertensive monopharmacotherapy and zinc metabolism alterations affect lipid metabolism, the oxidative state, and the inflammatory state.

Introduction: L-arginine (L-arg) and vitamin C supplementation may decrease fat accumulation and have a favourable effect on carbohydrate metabolism. This is partly caused by matrix metalloproteinases (MMPs), which are involved in adipocyte development and remodelling. Our study evaluated the effects of L-arg and vitamin C supplementation on the content of visceral fat (VF%), activity of MMPs, and insulin resistance (IR) in rats fed a high-fat diet (HFD). Material and methods: The experiment was performed using 48 Wistar rats divided into four groups: Group 1 was fed a standard diet, Group 2 a HFD, Group 3 a HFD supplemented with L-arg (A), and Group 4 a HFD supplemented with L-arg and vitamin C (AC). The animals were euthanized after six weeks. The concentrations of serum glucose, insulin, MMP-2, and MMP-9, as well as IR by Homeostatic Model Assessment (HOMA) and VF% were measured. Results: Statistically significant increases in VF%, MMP-2, MMP-9, insulin, and HOMA-IR levels were observed in the HFD group when compared to the control group. A smaller increase in VF%, insulin, and HOMA-IR was seen in Group 3 (A) and 4 (AC). L-arg supplementation protected against increases in MMP-2 and MMP-9 in Group 3 (A) and 4 (AC). Conclusions: L-arginine could protect from an increase in visceral fat through a change in the activity of MMPs and amelioration of insulin sensitivity in rats fed a HFD. The addition of vitamin C did not improve the effects of L-arginine supplementation. (Endokrynol Pol 2015; 66 (6): 526–532)

Aim: Without taking into consideration the pedagogical justification for doing the strength training by prisoners, the authors of this study discuss the problem of the consequences of allowing prisoners to do the strength training freely. The study was conducted to determine the frequency and the location of the overload changes in the musculoskeletal system of prisoners who do the strength training as well as the presumable reasons for such changes. Methods: The study was conducted with the use of an interview technique among 44 men, repeat offenders serving a sentence of imprisonment in a prison in Inowrocław, regularly engaged in strength training in their free time. Results: The respondents trained quite often (more than 5 times a week), slightly more than a half of them started the training with the warm up, and 64% did not do any stretching exercises after the training. The overload changes associated with strength training affected 30% of the respondents. Conclusion: The high level of injury among prisoners who do the strength training is due to: too many sessions a week, the lack of warm up and stretching exercises, as well as the insufficient level of knowledge on the prevention from sports injuries.

Papillary thyroid carcinoma (PTC), the most common thyroid cancer, is predominantly driven by mutations in BRAF (primarily p. V600E) and RAS oncogenes. Ultrasound (US) examination provides significant diagnostic data in the management of thyroid nodules, as many sonographic features of thyroid lesions are correlated with the potential risk of thyroid carcinoma. The aim of the study was to analyze the current literature in regard to the potential associations between genetic landscape and sonographic features of PTC. Based on the current literature, sonographic features of PTCs correlate with their molecular drivers, particularly between tumors harboring BRAFV600E versus activating RAS mutations, although many of these findings appear to be dependent on the tumor variant. Suspicious US findings, such as hypoechogenicity, spiculated/microlobulated margins, non-parallel orientation/taller-than-wide shape, and the presence of microcalcifications, are typical for PTC positive for BRAFV600E mutations. On the contrary, tumors with RAS mutations are most frequently hypo- or isoechoic and ovoid-to-round in shape, with smooth margins and without calcifications. There are also some US features typical for PTCs harboring other mutations, including BRAFK601E, RET/PTC rearrangements, PAX8-PPARγ, CTNNB1, and APC. However, further research is necessary, as some rare PTC variants still cannot be reliably analyzed due to the scarce published data.

INTRODUCTION: Poor antioxidant protection of cardiomyocytes due to cardiac ischemia and low serum levels of reduced glutathione (GSH) may be associated with enhanced risk of coronary restenosis after primary percutaneous coronary intervention (pPCI). OBJECTIVES: The aim of this study was to investigate whether preprocedural serum reduced GSH, reflecting the antioxidant status, may be predictive of major adverse cardiac events (MACE) in patients with acute coronary syndrome (ACS) treated with pPCI. PATIENTS AND METHODS: Preprocedural serum GSH level was evaluated in 141 patients with ACS treated with pPCI with bare-metal stent (BMS) deployment. During a 15-month follow-up, 30 patients (mean age, 61 ±10 years) experienced a MACE. The remaining 111 subjects constituted the non-MACE group (mean age, 63 ±10 years). RESULTS: The MACE group had significantly lower GSH levels compared with the non-MACE group (P 2.26; 2.09-2.99 μmol/l; P

Introduction Rape and pedophilic child molestation are the most commonly convicted sexual offenses in Poland. Recent studies have suggested a possible genetic contribution toward pathologic sexual interests and behaviors. Aim To analyze and compare functional polymorphisms of genes associated with the activity of the serotonin and dopamine systems in a group of paraphilic sexual offenders and control subjects. Methods The study sample (n = 97) consisted of two groups: paraphilic sexual offenders (65 pedophilic child molesters and 32 rapists) and controls (n = 76). Genetic polymorphisms previously associated with behavioral control, addictive behaviors, and sexual functions were chosen for analyses. Specifically, functional polymorphisms in dopamine receptors genes (DRD1, DRD2, DRD4), catechol-O-methyltransferase gene (COMT), dopamine transporter gene (DAT), serotonin transporter gene (SLC6A4), serotonin type 2A receptor gene (5HTR2A), tryptophan hydroxylase 2 gene (TPH2), monoamine oxidase A gene (MAOA), and brain-derived neurotrophic factor gene (BDNF) were analyzed. Main Outcome Measures An association between a history of sexual offense and the distribution of genotypes and alleles in the analyzed polymorphisms. Results Our results found no association between a history of sexual offense and the distribution of genotypes or alleles in the analyzed polymorphisms. Conclusion Although these results are limited by the small sample and are exploratory, they highlight a novel approach to sample selection in a population that is difficult to access and study. Future research should include larger samples and other relevant polymorphisms to advance this field of study.

Pseudocysts account for approximately 70% of all cystic lesions of the pancreas. One of the most dangerous complications of pancreatic pseudocysts is bleeding into the cystic lumen; the most common cause of the bleeding is a splenic artery pseudoaneurysm rupture. This paper presents the case of a 37-year-old man treated surgically for a massive intra–abdominal haemorrhage caused by a splenic artery pseudoaneurysm rupture into the lumen of a tail of pancreas pseudocyst with its subsequent perforation into the abdominal cavity and retroperitoneal space. Peripheral resection of the pancreas together with the cyst and spleen resection was performed. There were no postoperative complications.

The study was designed to assess blood platelet sensitivity to acetylsalicylic acid and its associations with dyslipidaemia and inflammation in coronary artery disease patients. Platelet non-responsiveness to aspirin is associated with an increased risk of serious cardiovascular events. Several environmental and hereditary factors are reportedly involved in sub-optimal acetylsalicylic acid response. Forty-five coronary artery disease patients and 45 non-coronary artery disease controls received acetylsalicylic acid at a daily dose of 75-150 mg. Controls were examined twice: on the day of entering the study and 10 days later. Urinary 11-dehydrothromboxane B2 was assessed as the marker of platelet thromboxane generation. Aggregation was studied in platelet-rich plasma using turbidimetric aggregometry with collagen and arachidonic acid. Fifty to seventy percent of coronary artery disease patients showed an extent of collagen-induced aggregation above the upper quartile of the reference range compared with 8-15% in controls (P

The effect of chronic hyperglycaemia on blood platelet response to acetylsalicylic acid was studied in rats with experimental diabetes. Platelet aggregation was determined in non-diabetic and streptozotocin-diabetic rats treated orally with 4 or 40 mg aspirin (ASA)/kg per day (for 8 weeks from the eighth day of diabetes) using whole blood impedance aggregometry with arachidonic acid or ADP as platelet agonists. The dose-dependent effect of ASA 'therapy' on ADP-agonized platelets was significant only in non-diabetic animals, while in diabetic rats both doses were ineffective in reducing ADP-stimulated platelet aggregation. ASA-mediated increased acetylation of platelet proteins favoured reduced platelet aggregation and slower platelet disaggregation (P r < 0.025 or less). Interestingly, however, the occupation of platelet protein-free amino groups was significantly higher in control rats compared with diabetic rats (P < 0.001), pointing out that proteins of platelets in non-diabetic animals were more vulnerable for the ASA-induced acetylation. We conclude that chronic hyperglycaemia interferes with preventive effects of ASA on platelet reactivity. Our data validate the suggestion that the relationship between aspirin ineffectiveness and poor metabolic control, first revealed in humans, concerns also other animals' platelets and holds regardless of the model or type of diabetes.

Introduction: Interventional procedures, such as percutaneous coronary intervention (PCI) have significantly improved the prognosis in patients with acute coronary syndromes (ACS). Despite the introduction of new methods the problem of in-stent restenosis in coronary arteries is still being discussed. Therefore finding predictors of this process is crucial. Elevation of C-reactive protein (CRP) can be a useful predictor for restenosis and other major adverse cardiac events (MACE) after PCI. Material and methods: The studied group consisted of 33 patients (23 males and 10 females; mean age 62.9±8.9) admitted to our Department with myocardial infarction (MI) in whom MACE occurred during 6 months follow-up period. The control group consisted of 33 patients (21 men and 9 women; mean age 61.8±9.8) admitted to hospital for MI, in whom no MACE occurred during 6 months follow-up period. In all patients coronarography was performed and concentrations of CRP were measured, using high sensitivity diagnostic ELISA method (hsCRP). An incorrect level was determined as higher than 6 mg/dl. Patients have been observed during 6 months follow-up. History data were taken from everyone, including information about incidences of MACE or restenosis. Results: Both studied groups did not differ in parameters describing: sex, age and number of people. In patients with MACE, mean CRP concentration was significantly higher (median 4.8 mg/dl ±; 1.9-11.4) in comparison with the control group (median 2.2; 1.3-4.3); p

The paper describes a case of exceptionally rare crossed embolism of the coronary artery. The embolus material originated in bone-marrow released from rib fractures which occurred during resuscitation attempts. Autopsy did not reveal any anatomical abnormalities of the circulatory system, nor any disease-related changes, which could explain the occurrence of this embolism type, and therefore the only possible explanation is the presence of direct connections between pulmonary arteries and veins. The confirmation of this theory is the bone-marrow embolism of the pulmonary vein detected in the second case.

L-arginine (L-arg) and vitamin C supplementation may decrease fat accumulation and have a favourable effect on carbohydrate metabolism. This is partly caused by matrix metalloproteinases (MMPs), which are involved in adipocyte development and remodelling. Our study evaluated the effects of L-arg and vitamin C supplementation on the content of visceral fat (VF%), activity of MMPs, and insulin resistance (IR) in rats fed a high-fat diet (HFD).The experiment was performed using 48 Wistar rats divided into four groups: Group 1 was fed a standard diet, Group 2 a HFD, Group 3 a HFD supplemented with L-arg (A), and Group 4 a HFD supplemented with L-arg and vitamin C (AC). The animals were euthanized after six weeks. The concentrations of serum glucose, insulin, MMP-2, and MMP-9, as well as IR by Homeostatic Model Assessment (HOMA) and VF% were measured.Statistically significant increases in VF%, MMP-2, MMP-9, insulin, and HOMA-IR levels were observed in the HFD group when compared to the control group. A smaller increase in VF%, insulin, and HOMA-IR was seen in Group 3 (A) and 4 (AC). L-arg supplementation protected against increases in MMP-2 and MMP-9 in Group 3 (A) and 4 (AC).L-arginine could protect from an increase in visceral fat through a change in the activity of MMPs and amelioration of insulin sensitivity in rats fed a HFD. The addition of vitamin C did not improve the effects of L-arginine supplementation.

On the ground of existing hitherto reports it is suggested that the "white coat effect" is not correlated with a high risk of cardiovascular diseases. Conducted studies did not ascertain a correlation between the value of the "white coat effect" and late diabetic complications. The aim of this study was to evaluate the risk of late diabetic complications: polyneuropathy, retinopathy and nephropathy in type 2 diabetic, hypertensive patients, in which the "white coat effect" was detected.The study comprised 67 type 2 diabetic, hypertensive patients. In all cases blood count, creatinine and urea serum concentration, urine examination, kidney ultrasonography were performed as well as neurological and ophtalmological examinations. Blood pressure values were measured with the use of mercurial sphygmomanometer during clinic visits. In all patients ambulatory blood pressure measurements (ABPM) were conducted. The "white coat effect" was detected when mean "systolic office blood pressure" values were10 mmHg higher than mean systolic blood pressure in ABPM-day and mean "diastolic office blood pressure" values were5 mmHg higher than mean diastolic blood pressure in ABPM-day.The patients were devided into two groups depending on the presence of the "white coat effect". Group 1 (n = 41) consisted of patients with the "white coat effect" and the second group (n = 26) without this phenomen. There were differences between the studied groups in systolic and diastolic blood pressure values estimated by traditional blood pressure measurement during clinic visits (p0.05). Systolic and diastolic blood pressure values estimated in ambulatory conditions with the use of ABPM were comparable in both groups (p0.05). The number of late diabetic complications in patients did not differ in both of the studied groups (p0.05).The "white coat effect" has not got an influence on polyneuropathy, retinopathy and nephropathy in type 2 diabetic patients with arterial hypertension.

The frequency of onset of acute coronary syndromes and sudden cardiac death has been reported to have circadian variations, with a peak incidence in early morning hours. It has also been known that acute ischemia is a potent stimulus to increased dispersion of repolarization and development of malignant arrhythmias. QT dispersion (QTd) is used as an index of heterogenity of the ventricular repolarization and increases in patients with ischemic heart disease. The aim of the study was to investigate diurnal variations of QTd in patient with triple-vessel coronary artery disease (CAD) with and without diabetes mellitus type 2 (DM).We investigated of 28 patients with stable triple-vessel CAD and 32 patients with similar advancement of changes in coronary circulation with co-existing DM. We excluded patients with prior myocardial infarction, taking oral medications which might alter QT interval and patients in which measurements of QT were difficult to perform or impossible. QTd measurements were taken semi-automatically every hour from 24 hours 12 leads Holter monitoring system (SUPRIMA 12). Measurements were verified independently by three observers.CAD patients without DM had QTd significantly greater in the morning hours (6 a.m. to 9 a.m.) in comparison with the other times (p0.01). The shortest QTd was measured during the night between 10 p.m. and 1 a.m. We did not observed circadian variations of QTd in patients with co-existent DM and values of QTd in this group was significantly greater then in CAD without DM group (p0.001).Our data proved that QTd in patients with CAD had a circadian variation with a peak value in the morning hours shortly after awakening. Patients with DM and CAD had not circadian variation of QTd but QTd values, during whole day and night, were significantly greater then patients without DM.

Detection of reduced aspirin effectiveness has gained significant importance since clinical consequences of aspirin resistance were reported. Nevertheless, due to differentiated molecular basis of aspirin resistance, the conflicting choice of referential method for detection of acetylsalicylic acid ineffectiveness has become troublesome. This study, using a rat model of antiplatelet therapy, examines the aptitude of selected TXB2 metabolism-based methods in the detection of acetylsalicylic acid effectiveness. We hypothesized that ex-vivo whole blood spontaneous TXB2 generation assay could be, contrary to basal TXB2 and urine 11-dTXB2, a novel surrogate measure for impaired acetylsalicylic acid-dependent inhibition of thromboxane synthesis. To address this hypothesis, we evaluated the sensitivity of TXB2 generation assay in hirudinized whole blood to detect acetylsalicylic acid-mediated inhibition of cyclooxygenase activity in healthy rats and diabetic rats treated with acetylsalicylic acid. In diabetic and control animals, both acetylsalicylic acid drenches in the dose-independent manner contributed to significant attenuation of basal plasma TXB2 and urinary 11-dTXB2 formation. Urinary concentrations of 11-dTXB2 were, contrary to basal TXB2, significantly higher, regardless of acetylsalicylic acid dose, among all diabetic groups, compared with corresponding control groups. Determination of TXB2 generation in whole blood enabled sensitive detection of dose-related acetylsalicylic acid effect in both groups, as well as increased TXB2 formation in diabetes. We showed for the first time that evaluation of spontaneous generation of TXB2 in hirudinized whole blood enables, contrary to basal plasma TXB2 and urine 11-dTXB2 concentrations, to sensitively determine the acetylsalicylic acid effect in healthy and diabetic subjects.

The aim of this study was to evaluate the efficacy of chronic therapy with fosfomycin trometamol (TF) in the treatment and prevention of recurrent, uncomplicated urinary tract infections (NIDDM) in type 2 diabetic women.The study comprised 45 type 2 diabetes women aged 50-70 years. All patients enrolled into the study suffered from the NIDDM presented with clinical signs of uroinfection and positive urine culture with bacterial uropathogen sensitive to TF. Study period lasted 12 months and during the first 9 months patients were treated with TF. The patients remained under regular medical supervision in diabetic outpatient clinic every 3 months. Efficacy of treatment was proved when both clinical cure and uropathogen eradication were achieved in 3, 6, 9 or 12th month from the study beginning.The difference in efficiency of fosfomycin treatment after 3 months of the study duration in comparison with duration before study beginning was statistically different (p0.001). The differences in efficiency of fosfomycin treatment after 6 months of study duration in comparison with time before 3 months were statistically different (p=0.03). There was not statistically differences in efficiency of fosfomycin treatment between the 6th and 9th month of study duration (NS).Fosfomycin is the safe and effective antimicrobial method to cure and prevent NIDDM.

"White coat hypertension" is a phenomenon in which patients exhibit elevated blood pressure in clinical setting, but not recorded by themselves at home.The aim of this study was to evaluate frequency of "white coat hypertension" in type 2 diabetic patients, in which high blood pressure values in clinical setting were observed for the first time.The study comprised 52 type 2 diabetic patients with newly diagnosed high blood pressure values in measurements with the use of mercurial sphygmomanometer during ambulatory visit (mean "office blood pressure" valuesor =140/90 mmHg). In all patients ambulatory blood pressure measurements (ABPM) were conducted. "White coat hypertension" was detected when the mean blood pressure value in ABPM during the day was135/85 mmHg and the mean "office blood pressure" wasor =140/90 mmHg. Arterial hypertension was detected when the mean "office blood pressure" values wereor =140/90 mmHg and the mean blood pressure value in ABPM during the day wereor =135/85 mmHg.In forty-four percent of the studied patients "white coat hypertension" was diagnosed (group 1). Group 2 consisted of patients with arterial hypertension (56% of all studied patients). Blood pressure values estimated on the ambulatory basis with the use of ABPM were lower in group 1 than in group 2 (p0.05). There were no differences between the study groups in blood pressure values estimated by traditional method with the use of mercurial sphygmomanometer during clinic visit (p0.05).In above 2/5 of type 2 diabetic patients with newly detected high blood pressure during clinic visits, "white coat hypertension" was diagnosed.

The aim of this study was to comprise the efficacy of chronic therapy with fosfomycin, co-trimoxazole and nitrofurantoin in the treatment and prevention of recurrent urinary tract infections (UTI) in type 2 diabetic women.The study comprised 90 women aged 50-70 years, who suffered from the UTI (isolated bacterial uropathogen sensitive to fosfomycin, co-trimoxazole and nitrofurantoin). Women were divided into 3 groups. Group I comprised patients, who have been treated with fosfomycin, group II with co-tromixazole and group III with nitrofurantoin. Observation period lasted 9 months and for the 6 months patients were treated with antimicrobial agents. Efficacy of antimicrobial treatment was estimated when both clinical cure and bacteriological eradication of uropathogens were achieved.There were no significant differences in the percentage of patients between study groups, who achieved therapeutic successes after 3 and 6 months of the antimicrobial treatment (NS). Three months after discontinuation of treatment episodes of UTI were observed significantly rarely in group treated with fosfomycin in comparison with the group treated with nitrofurantoin (p = 0.01) and co-trimoxazole (p = 0.02).Fosfomycin, co-trimoxazole and nitrofurantoin are safe and effective antimicrobial methods to cure and prevent UTI. Fosfomycin is associated with rarely recurrence of UTI than nitrofurantoin and co-trimoxazole in the period without its taking.

Etiopathogenesis of vascular complications in diabetes is complex and multifactorial. One of the factors that is connected both with chronic complications of diabetes and intensification of oxidative stress is long-term hyperglicaemia. It has been noted that control improvement of glicaemia delays and/or inhibits the development of further complications. The aim of the study was to evaluate selected parameters of oxidative stress in patients with metabolic compensated or decompensated diabetes by means of marking in red blood cells of the patients in question the activity of antioaxidative enzymes such as: superoxide dysmutase (SOD-1) and catalase (CAT) and concentration of malondialdehyde (MDA). 61 diabetic patients took part in the research, 31 of which met the criteria of metabolic compensation whereas 30 were metabolically decompensated. The reference group (K) consisted of 40 healthy men. The activity of SOD-1 was marked by Misra and Fridovich's method, the activity of CAT by Beers and Sizer's method and the concentration of MDA in red blood cells was indicated by Placer et al. The activity of evaluated antioxidative enzymes SOD-1 and CAT in the erythrocytes of diabetes type 2 patients was statistically lower as compared with the control group. The highest activity of SOD-1 and CAT was noted in metabolic decompensated diabetes type 2 group. The concentration of MDA in diabetes type 2 patients red blood cells was significantly higher as compared with the control group. Significantly higher concentration of MDA was noted in metabolically decompensated diabetic patients comparing to patients with proper metabolically compensated diabetes. The obtained results confirm the toxicity of glucose. Long-term hyperglicaemia through activation of different metabolic paths leads to the intensification of free radical processes and attenuation of antioxidative mechanisms.

Both effective treatment of arterial hypertension and prevention from its complications are considered very important issues, especially in a population of elderly people, in whom hypertension occurs along with other risk factors, resulting in increase of incidence of myocardial infarction and stroke.There were assessed an influence of 6-month ambulatory cardiac rehabilitation on level of resting and peak systolic and diastolic arterial pressure in elderly patients with chronic ischemic heart disease (IHD) and arterial hypertension (AH), likewise relations between the pressure alterations and the age of the examined patients.A group of 70 patients with IHD and AH treated invasively was subjected to a rehabilitation program. Group A consisted of 37 patients with the mean age of 69.0 +/- 0.5 years, and group B of 33 patients with the mean age of 51.5 +/- 0.5 years. The patients from the both groups differed significantly only as to the age, whereas they were comparable regarding current clinical status, echocardiographical parameters, BMI values and applied pharmacological treatment. During a follow-up period, neither drug regimen, established at least three months earlier, nor a diet were not modified. The all patients underwent a 6-month cardiac rehabilitation, combining exercises on cycle ergometers (3 times per week) and generally improving training (2 times per week). There were analyzed: the mean values of resting and of peak systolic and diastolic blood pressure at the beginning of the rehabilitation and upon completion of the program.Comparison of the patients from groups A and B did not reveal any significant differences concerning the initial mean values of both resting and peak pressure (systolic and diastolic). Just after the rehabilitation finishing, in A group, a statistically significant reduction of resting systolic and diastolic pressure, likewise insignificant reduction of peak systolic and diastolic pressure were observed. Contrarily, in B group, it was noted a significant reduction of resting systolic and diastolic pressure and insignificant reduction of peak diastolic pressure. In this group, yet, an insignificant increase of peak systolic pressure was found. In the both groups, there was no statistically significant correlation between the age and the delta values of resting and peak systolic and diastolic pressure.Long-term ambulatory cardiac rehabilitation caused a profitable blood pressure lowering in patients with IHD and AH, regardless of the age. A changes intensity of resting and of peak blood pressure did not show a dependence on the patients' age.

Ongoing with age decline of physical capacity reflects permanent processes of aging occurring in organism. It leads to a successive reduction of physical activity level, resulting with time in restrictions of independent life ability, which then causes anxiety and progressing social isolation.Evaluation of relation between age and effort tolerance in patients with chronic ischemic heart disease and comparison of cardiac rehabilitation effects in two patient groups at significantly various age.The study comprised 103 patients (69 males and 34 females) at the mean age of 61.2 +/- 0,8 years. The patients were referred to rehabilitation because of undergone invasive treatment of IHD, using CABG (44 pts) and PTCA (48 pts), or acute coronary syndromes (11 pts). The study group was divided to the two subgroups, "A" and "B", differing significantly (p0.01) from each other by age. "A" group was constituted by 30 the youngest patients, with the mean age of 51.6 +/- 0.5 yrs, whereas "B" group comprised 30 the oldest patients, with the mean age of 70.9 +/- 0.6 yrs. The examined groups were comparable as to the drug treatment, clinical status, echocardiographic parameters and BMI values. During the observation period no changes in treatment and diet were made. The all patients were subjected to six-month cardiac rehabilitation, consisting of cycle ergometer training (3 times/week) and generally improving exercises (2 times/week). The parameters analyzed were the values of metabolic equivalent (MET) obtained at the initial and the final exercise treadmill test, likewise the delta of MET.For a population of 103 patients with IHD, the negative, statistically significant correlation Pearson's coefficient between age and MET values of initial and final exercise tests and insignificant Pearson's coefficient between age and values of MET delta were obtained. Comparison analysis of the mean MET of initial and final exercise test and the mean MET delta did not show any significant differences between the both examined "A" (young) and "B" (old) groups.In the examined patients with IHD, there were observed a negative, significant correlation between age and effort tolerance before and after the cardiac rehabilitation cycle, and a lack of significant correlation between age and delta of effort tolerance. There was found no considerable difference concerning a delta of effort tolerance between the patients with IHD falling into the young and the old groups.

We describe the role of plasma and platelet cholesterol content in the ability of acetylsalicylic acid (ASA) to acetylate platelet proteins and inhibit platelet function. Platelet susceptibility to ASA was monitored in subjects differing in plasma total cholesterol and in suspensions of cholesterol-enriched or cholesterol-depleted platelets. Platelets from subjects with higher plasma cholesterol (> 6 mmol/l) showed reduced platelet sensitivity to ASA (inhibition of platelet aggregation and thromboxane generation by 60% and 68% in ‘lower-‘ vs. 32% and 56% in ‘higher-cholesterol’ donors; n = 13 in each group; p = 0.056 and p

There is a growing number of contradictory reports indicating that adenosine diphosphate (ADP) can be a useful agonist in monitoring of the antiplatelet action of acetylsalicylic acid (ASA) in humans and animals. In the current study, we aimed to determine the conditions for using ADP to trigger platelet aggregation in order to detect ASA-mediated inhibition of rat platelet reactivity. Initially, we examined the usefulness of different ADP concentrations (0.25, 0.5, 1, 5 and 10 microM) in detecting the in vitro ASA mediated platelet inhibition using whole blood aggregometry, as well as we monitored the role of ADP in generation of thromboxane A(2) (TXA(2)). To study ex vivo ASA inhibitory potential on platelet aggregation induced by a range of ADP concentrations, animals were subjected to one or 10-day ASA administration at the dose of 50 mg/kg. Our experiment shows that ADP in a concentration-dependent manner induces TXA(2) generation in the whole blood with hirudin as an anticoagulant. However, in vitro and ex vivo examination of ASA inhibitory potential on platelet aggregation revealed that irrespectively of administration regimen, ASA failed to block platelet aggregation induced by ADP at the concentrations higher than 0.5 microM. Our findings suggest that the mechanism of ADP-induced platelet aggregation depends on agonist concentration. It appears that only low ADP concentrations (up to 0.5 microM) induce TXA(2)-dependent rat platelet aggregation. Therefore, ADP could be considered a useful platelet agonist for monitoring of ASA-mediated platelet inhibition only if used at much lower concentrations than those commonly employed.

Arterial hypertension is one of the most common health problems occurring in highly developed countries. It was proved that long-term and regular physical activity results in hypotensive effect.A goal of the present study was to assess an influence of six-month ambulatory cardiac rehabilitation on arterial pressure level in patients with coronary artery disease and hypertension as well as analysis of correlation between pressure values alterations and intensity of cardiac training.A study group comprised 103 patients (mean age: 61.2 +/- 0.8 years) manifesting coronary artery disease accompanied by arterial hypertension. A control group constituted 39 normotensive patients with coronary artery disease (mean age: 59.4 +/- 1.3 years). The both observed groups differ from each other only with values of left ventricle mass index and drug regimen established at least three months prior to the follow-up onset. During the rehabilitation cycle, no treatment corrections were made and no new preparations were added. The all patients were enrolled to the six-month cardiac rehabilitation program. The program comprised 45-minute training with cycle ergometer, three times a week, and generally improving gym exercises, two times a week. The analyses concerned systolic and diastolic pressure values, measured just before each training (resting pressure) and just after peak exercise interval (peak pressure), at the beginning and at the end of the rehabilitation cycle. At the initial stage, the patient group with hypertension demonstrated the higher pressure values (resting and peak), as compared with the control group.Cardiac rehabilitation performed in the examined patients caused a statistically significant reduction of the mean resting pressure, both systolic (p0.01) and diastolic (p0.01). As to the mean peak pressure in this group, systolic diminished slightly (NS), but diastolic was reduced significantly (p0.01). In the control group, after six-month rehabilitation the values appeared to be lowered insignificantly in relation to systolic and diastolic resting pressure, likewise diastolic peak pressure, and contrarily systolic peak pressure increased slightly. Assessing an interrelation between the final outcome of the rehabilitation program, expressed as delta of arterial pressure, and terminal training workload and delta of training workload, only for delta of systolic pressure and final training workload, a positive correlation of statistical significance was found out, which is considered an implication of physiological reaction against an increase of training workload.Long-term and regular cardiac training induced the larger alterations of pressure values in the patients with hypertension, as compared with the normotensive patients. A positive effect of cardiac rehabilitation on arterial pressure level in the hypertensive patients was found to be independent of the training intensity.

A goal of the study was to investigate the interrelations between body mass index (BMI) and arterial pressure level and its alterations induced by a long-term cardiac rehabilitation. In the patients with arterial hypertension with concomitant ischemic heart disease (IHD). The study group consisted of 73 patients (46 males and 27 females), with age range 54-64 years (the mean: 59.59 +/- 0.67 years), subjected to the 6-month ambulatory supervised cardiac rehabilitation, which comprised stamina training with cycloergometer combined with generally improving exercises. Arterial pressure level was measured in the resting state (just before the training onset) and at the interval training peak (peak pressure) during the consecutive three initial and three final training sessions. Upon completion of the rehabilitation cycle, statistically significant reduction of resting systolic pressure: 116.85 +/- 1.68 mmHg vs 105.12 +/- 1.43 mmHg (p0.01) and insignificant reduction of resting diastolic pressure 79.85 +/- 1.24 mmHg vs 77.44 +/- 1.21 mmHg (NS) were observed. Additionally, insignificant lowering both systolic and diastolic peak pressure was noted, respectively: 119.45 +/- 1.92 vs 118.75 +/- 2.3 mmHg and 78.63 +/- 1.22 mmHg vs 76.96 +/- 1.30 mmHg. Correlation analysis concerning the values of resting systolic and diastolic pressure, likewise of peak systolic and diastolic pressure, on the one hand, and the values of body mass index, on the other hand, yielded in the all considered cases the statistically insignificant positive Pearson's coefficients. The further dependence analyzed, between the delta of resting and peak pressure, systolic and diastolic, and the body mass index values was featured by the insignificant statistically negative correlation coefficients. In result of the 6-month rehabilitation, 36 out of 73 patients demonstrated BMI value reduction by 0.65 +/- 0.33, which did not affect significantly an extent of the arterial pressure lowering. Therefore, in the examined patient group with hypertension and IHD, body mass index turned out to determine neither the initial nor the after-rehabilitation pressure levels, both systolic and diastolic.