Body mass index and partial remission in 119 children with type 1 diabetes—a 6-year observational study

Background/objectiveThis long-term study aimed to analyze the associations between BMI Z-score, HbA1c, and daily insulin requirement (DIR) and the prevalence and duration of partial remission (PR) in children and adolescents with type 1 diabetes (T1D).MethodsAfter retrieving retrospective data for 195 patients from their health records at 24, 48, and 72 months after T1D diagnosis, the study group was comprised of 119 (57 girls) children with a complete dataset for all 6 years. PR was defined according to the ISPAD guidelines. Analyses were carried out in the whole group and subgroups according to PR duration: no PR at all (NPR), PR lasting less than 2 years (PR < 2), and PR at least 2 years (PR ≥ 2).ResultsPR was observed in 63% of the patients (78.9% of overweight and 100% of obese patients). NPR patients showed the lowest mean initial BMI Z-score [−0.65 ± 1.29 vs. 0.02 ± 1.42, (PR < 2), p = 0.01 and vs. 0.64 ± 1.43 (PR ≥ 2), p = 0.17]. The dissimilarity in BMI across patients declined over time. Within the NPR group, the initial mean BMI Z-score significantly increased within the first 2 years (unadjusted p < 0.001) and remained constant afterward. In the PR <2 group, the highest increase in BMI Z-score occurred after 4 years (p < 0.001) and then decreased (p = 0.04). In the PR ≥2, the BMI Z-score slightly decreased within the first 2 years (p = 0.02), then increased (p = 0.03) and remained unchanged for the last 2 years. Six years after T1D started, the mean DIRs do not differ among the patient groups (ANOVA p = 0.272).ConclusionDuring 6 years of follow-up, PR occurred in almost two-thirds of the studied children including almost all overweight and obese children. We observed a gradual normalization of the BMI Z-score at the end of the follow-up. BMI Z-score increased slightly in children with no remission initially but remained later constant until the end of observation. In both remitter groups, the increase in BMI Z-score appeared later when the protective honeymoon period ended. Regardless of BMI Z-score, the β-cell destruction process progresses, and after 6 years, the DIR is similar for all patients

In Search of New Therapeutics—Molecular Aspects of the PCOS Pathophysiology: Genetics, Hormones, Metabolism and Beyond

In a healthy female reproductive system, a subtle hormonal and metabolic dance leads to repetitive cyclic changes in the ovaries and uterus, which make an effective ovulation and potential implantation of an embryo possible. However, that is not so in the case of polycystic ovary syndrome (PCOS), in which case the central mechanism responsible for entraining hormonal and metabolic rhythms during the menstrual cycle is notably disrupted. In this review we provide a detailed description of the possible scenario of PCOS pathogenesis. We begin from the analysis of how a set of genetic disorders related to PCOS leads to particular malfunctions at a molecular level (e.g., increased enzyme activities of cytochrome P450 (CYP) type 17A1 (17a-hydroxylase), 3b-HSD type II and CYP type 11A1 (side-chain cleavage enzyme) in theca cells, or changes in the expression of aquaporins in granulosa cells) and discuss further cellular- and tissue-level consequences (e.g., anovulation, elevated levels of the advanced glycation end products in ovaries), which in turn lead to the observed subsequent systemic symptoms. Since gene-editing therapy is currently out of reach, herein special emphasis is placed on discussing what kinds of drug targets and which potentially active substances seem promising for an effective medication, acting on the primary causes of PCOS on a molecular level

External quality monitoring facilitates improvement in already well-performing stroke units: insights from RES-Q Poland

Introduction. The Registry of Stroke Care Quality (RES-Q) is used in Poland for quality monitoring by numerous hospitals participating in the Angels Initiative. Our aim was to assess the degree of improvement in highly stroke-oriented centres that report cases to the RES-Q each year. Material and methods. This retrospective analysis included Polish stroke units that from January 2017 to December 2020 contributed to the RES-Q at least 25 patients annually. Results. Seventeen out of 180 Polish stroke units reported patients each year (2017, n = 1,691; 2018, n = 2,986; 2019, n = 3,750; 2020, n = 3,975). The percentage of ischaemic stroke patients treated with alteplase remained stable (26%, 29%, 30% and 28%, respectively). The door-to-needle time progressively decreased, from a median 49 minutes to 32 minutes. The percentage of patients treated ≤ 60 minutes and ≤ 45 minutes significantly increased (from 68% to 86% and from 43% to 70%, respectively), with no change observed between 2019 and 2020. Despite a general improvement in dysphagia screening (81%, 91%, 98% and 99%), screening performed within the first 24h from admission became less frequent (78%, 76%, 69% and 65%). In-hospital mortality significantly increased (11%, 11%, 13% and 15%), while the proportion of patients discharged home remained stable. Conclusions. Quality-oriented projects facilitate the improvement of stroke care, even in centres demonstrating good baseline performance. Polish stroke units that consistently reported cases to the RES-Q demonstrated improvement in terms of door-to- -needle time and dysphagia screening. However, there is still a need to shorten the time to dysphagia screening, and carefully monitor stroke unit mortality following the COVID-19 pandemic

Breast cancer risk variants at 6q25 display different phenotype associations and regulate ESR1, RMND1 and CCDC170.

We analyzed 3,872 common genetic variants across the ESR1 locus (encoding estrogen receptor α) in 118,816 subjects from three international consortia. We found evidence for at least five independent causal variants, each associated with different phenotype sets, including estrogen receptor (ER(+) or ER(-)) and human ERBB2 (HER2(+) or HER2(-)) tumor subtypes, mammographic density and tumor grade. The best candidate causal variants for ER(-) tumors lie in four separate enhancer elements, and their risk alleles reduce expression of ESR1, RMND1 and CCDC170, whereas the risk alleles of the strongest candidates for the remaining independent causal variant disrupt a silencer element and putatively increase ESR1 and RMND1 expression.This is the author accepted manuscript. The final version is available from Nature Publishing Group via http://dx.doi.org/10.1038/ng.352

'Black hole of 1980'? Representation of last decade od Polish People's Republic based on selected works of authors born in 1960' and 1970'.

Tematem pracy jest obraz lat osiemdziesiątych, słabo obecnych w powszechnej świadomości, wyłaniający się z utworów powstałych po roku 1989. Przedmiotem analizy są kolejno „Jak zostałem pisarzem (próba autobiografii intelektualnej)” Andrzeja Stasiuka, część tomu „Artyści, wariaci, anarchiści: [opowieść o gdańskiej alternatywie lat 80]” autorstwa Krzysztofa Skiby, „Wroniec” Jacka Dukaja, oraz opowiadania „Kolaboracja” i „Mosina” Michała Witkowskiego. Pamięć o wydarzeniach miesza się w nich ze stereotypami i kliszami, celem pracy jest wiec porównanie podejścia do tych schematów myślenia i sposobów ich wykorzystania.The work presented is devoted to the representation of 1980', weakly present in the common consciousness, which emerges from texts written after 1989. In works analized, 'Jak zostałem pisarzem (próba autobiografii intelektualnej)' by Andrzej Stasiuk,part of 'Artyści, wariaci, anarchiści: [opowieść o gdańskiej alternatywie lat 80]' written by Krzysztof Skiba, 'Wroniec' by Jacka Dukaj, and stories 'Kolaboracja' and 'Mosina' by Michała Witkowskiego, memories mix with stereotypes and cliches. Thesis compares how authors deal with them and use them for their advantage

The story of the fall of the Home

Praca skupia się na analizie "Chochołów" Wita Szostaka pod kątem wizji domu i rodziny w niej przedstawionych i ich wzajemnego uwikłania, a także problemów z tożsamością wynikających z niemożności realizacji tradycyjnych wzorców. Przedstawia ona socjologiczne i antropologiczne wymiary poruszanych problemów i pokazuje jak powieść balansująca na granicy fantastyki przenikliwie i dogłębnie porusza współczesne problemy rodziny a także zagubienia, zatarcia tradycji, samotności, utopijności projektów życiowych i braku komunikacji międzyludzkiej.Thesis analizes 'Chochoły' written by Wit Szostak focusing on vision representation of home and family and their mutual entaglement. Also, presents identity crisis that is consequence of inability to implementation of traditional lifestyle patterns. The work presents sociological and anthropological aspects of analysed issues and shows how novel that is balancing on the border of fantasy acutely and deeply raises issues of contemporary family problems but also of being lost, lonely, issues of dying tradition, utopian life projects and lack of communication

Historia i specyfika działalności banków spółdzielczych w Polsce

Cooperative banks are a specific element operating in the banking system. They base their activities on the following normative acts, namely: Banking Law and related legal acts. In addition, their activity is also based on legal provisions within the scope of Cooperative Law. The particularity of the institutions under consideration lies in the fact that their main goal is not solely oriented towards obtaining the highest profits. The core of their functioning is oriented towards satisfying the needs of their members. The genesis and history of cooperative banking is long. Originally, the purpose of this type of institution, which over time evolved into what we know today as cooperative banks, was to take action to combat usury. Furthermore, the retained objectives of these institutions include the promotion of social development.Banki spółdzielcze są specyficznym elementem systemu bankowego. Ich działalność regulowana jest nie tylko przez Prawo bankowe oraz inne akty prawne dotyczące sektora bankowego, ale także Prawo spółdzielcze. Specyfika tych instytucji polega także na tym, iż nie działają wyłącznie dla osiągania jak najwyższych korzyści, lecz dla zaspokajania potrzeb swoich członków. Sama bankowość spółdzielcza ma dość długą historię. Pierwotnym celem instytucji, które z czasem przerodziły się w obecnie funkcjonujące banki spółdzielcze, była walka z lichwą oraz wspieranie rozwoju społecznego