Przewlekły proces zapalny u pacjentów z ostrymi zespołami wieńcowymi i przewlekłą chorobą nerek

Chronic kidney disease is a worldwide growing problem in public health. It is a risk factor for complications in patients with acute coronary syndrome (ACS). Diabetes, hypertension (hypertrophy and left ventricular failure), impaired fibrinolysis and coagulation processes, as well as the rapid development of atherosclerosis (partly associated with chronic inflammation) are responsible for higher prevalence of cardiovascular diseases in patients with chronic kidney disease. Inflammatory process of unknown aetiology belongs to the so-called non-traditional risk factors in development of cardiovascular system diseases. It is thought that this process is responsible for adverse remodelling of atherosclerosis plaque and its instability which causes plaque rupture and as a result a coronary syndrome occurrence. Important inflammatory mediators, which take part in pathogenesis of ACS, are acute phase proteins such as: C-reactive protein, adhesion molecules VCAM-1, ICAM-1, selectins, plasma amyloid A, metalloproteinases, interleukins-1 and -6, tumour necrosis factor-a and vascular endothelial growth factor. Kardiol Pol 2011; 69, 4: 388-39

Circulating omentin-1 levels and inflammation in polycystic ovary syndrome

Objectives: The aim of the study was to analyze interrelation between plasma omentin-1 levels and nutritional status andinflammation in PCOS.Material and methods: A cross-sectional study involving 86 PCOS (47 obese) and 72 Non-PCOS women (41 obese) determinedanthropometric parameters and body composition. Serum glucose, insulin and omentin-1, TNF-α, sTNFRs, IL-6 andsR-IL6 were measured in the fasting state.Results: Plasma omentin-1 levels were significantly lower in the PCOS than in the Non-PCOS group and both correspondingnormal weight and obese subgroups. In three analyzed least-angle regression (LARS) models the lower plasma omentin-1 levels was associated with PCOS occurrence, higher circulating TNF-α and lower IL-6 levels.Conclusions: Suppressed omentin-1 levels in PCOS are characteristic for this disturbance and proinflammatory cytokinesare factors modifying secretion of this adipokine

Circulating vaspin levels and nutritional status and insulin resistance in polycystic ovary syndrome

Objectives: The study aimed to assess the associations between circulating vaspin levels and nutritional status (assessedon tha basis of BMI) as well as insulin resistance in PCOS.Material and methods: Eighty-seven PCOS women, 48 obese and 39 normal weight, were enrolled in the cross-sectionalstudy. Seventy-two Non-PCOS women, 41 obese and 31 normal weight, constituted a control group. Body mass, height andwaist circumference as well as body composition by bioimpedance were measured. In the morning (16h after the last meal)we determined: serum glucose, insulin, androgens, gonadotropin (LH, FSH) and sex hormone-binding globulin (SHBG) aswell as plasma vaspin levels. Standard HOMA-IR formula was used to assess insulin resistance (IR).Results: Plasma vaspin levels were significantly lower in PCOS, both normal weight and obese, than in Non-PCOSgroups. Vaspin levels were similar in normal weight and obese PCOS subgroups. There was no association between plasmavaspin levels and anthropometric parameters in PCOS group. While in Non-PCOS group a negative correlation betweenplasma vaspin levels and body mass (r = –0.26; p < 0.05) was found. We did not observe correlations between plasma vaspinlevels and serum glucose and insulin concentrations as well as HOMA-IR values, however, in multivariable, stepwise backwardregression waist circumference and HOMA-IR values explained 18.0% of plasma vaspin levels variability in the study subjects.Conclusions: PCOS occurrence is associated with decreased vaspin levels. The influence of nutritional status on vaspin levelobserved in Non-PCOS is abolished in PCOS women, possibly by more severe insulin resistance

Six-minute walk test on a special treadmill: Primary results in healthy volunteers

Background: The guidelines approved by the American Thoracic Society in 2002 definitely recognize the six-minute walk test (6MWT) as a useful tool for the evaluation of physical efficiency in individuals with at least moderate chronic obstructive pulmonary disease, heart failure and intermittent dysbasia. So far, the American Thoracic Society has not approved the use of a treadmill to determine the six-minute walking distance (6MWD) because patients are unable to pace themselves on a treadmill. The purpose of our work was to prove that these problems could be avoided if physical efficiency is evaluated with the use of a modified treadmill. Methods: The work evaluates the function of a treadmill able to adjust its speed to the walking speed of healthy volunteers. The evaluation is based on a comparison of the distance covered by the healthy volunteers and the comfort of the test on the treadmill during six minutes with the distance covered and comfort during the same period in a 22-metre-long hallway in 29 healthy volunteers. Non-invasive blood pressure and pulse measurements were taken immediately before and after the test. Results: The average distance covered during the six-minute period on the treadmill was 57.1 m longer than in the hallway. The comfort of the treadmill test was indicated to be better by 18 subjects, worse by 4 subjects and identical by 7 subjects. Conclusions: The tests confirm that the speed of the modified treadmill adjusts properly to the walking speed of the healthy volunteers. The hemodynamic effects were identical for the healthy volunteers both in the hallway and treadmill tests. The distance differences were caused by turnarounds in the corridor test. The results obtained with the special treadmill allow us to develop a new method and, at present, provide a basis for a second stage of research comprising subjects with diagnosed heart failure. (Cardiol J 2007; 14: 447-452

The epidemiology of the most frequent cancers in Poland in 2015–2021 and the impact of the COVID-19 pandemic on cancer incidence

Abstract Background The late diagnosis, despite the improving availability and accessibility of diagnostic procedures during the last decade in Poland and cooperation between specialist cancer centres, remains an unsolved problem. Moreover, the accessibility to healthcare resources and diagnostic procedures has been drastically reduced because of the COVID-19 pandemic in 2019–2020. The study aimed to present the epidemiology of the most frequent cancers diagnosed in Poland as well as the impact of the COVID-19 pandemic on cancers’ incidence. Methods Depersonalized, epidemiological data was obtained from the National Health Fund of Poland. In this retrospective study, the epidemiological analysis was performed and divided into subregions, according to patients’ domicile. For each of the subregions, we have calculated the incidence rate per 100,000 standardized to the European Standard Population 2013. The time points of providing the first healthcare service were considered as the time of cancer diagnosis. Results In the 2015–2019 period, before the COVID-19 pandemic occurred, the nationwide incidence of analysed cancers remained stable or slightly decreased (as the lung cancer). Simultaneusly, during the same period the prevalence of the prostate cancer has increased and the large differences between subregions with the least and the highest incidence were observed. Subsequently, the incidences of all analyzed cancers decreased in 2020, compared to the period before the COVID-19 pandemic occurred. Then, in 2021 a disproportionate increase in cancers’ incidence rates was noted. Conclusions Our results show a significant decrease in the incidence rate of the most frequent cancers diagnosed in Poland in 2020 compared to 2019. Subsequently, in 2021 the increase of the incidence ratios was noted, most likely due to the gradual reduction of epidemic restrictions

Comparison of Adrenal Tumor Size in Ultrasound Examinations with and without the Use of a Contrast Agent

Background and objectives: Patients diagnosed with incidentally found adrenal tumors (incidentaloma) that do not meet the criteria for surgical treatment require follow-ups with repeated imaging. The aim of this study is to compare the accuracy of the measurements of the adrenal tumor size in ultrasound (US) with and without contrast in comparison to computed tomography (CT) or magnetic resonance (MRI). Further, this study attempts to answer the question of whether contrast-enhanced ultrasound (CEUS) can improve imaging accuracy and replace CT/MRI in the monitoring of patients with adrenal tumors. Materials and Methods: The retrospective analysis included 79 adult patients with adrenal incidentalomas not exceeding a dimension of 6 cm who underwent a CT or MRI scan, US, and CEUS with the use of SonoVue in two-dimensional (2D) and three-dimensional (3D) projections and Doppler techniques. Tumor vascularization in CEUS was classified as follows: peripheral, peripheral-central, central, or poor. Results: Of 79 adrenal tumors, 48.1% showed peripheral, 29.1% showed poor, 21.5% showed peripheral-central, and only 1.3% showed central vascularization. The median volume of tumors detected with CEUS (69.9 cm3) was significantly higher than with US (44.5 cm3) and CT or MRI (57.1 cm3). The relative error of the adrenal volume with CEUS compared with CT or MRI was significantly higher than with standard US, regardless of the type of tumor vascularization. Conclusions: CEUS does not improve the accuracy of adrenal tumor size assessment regardless of the type of vascularization

Are We Overdoing It? Changes in Diagnostic Imaging Workload during the Years 2010–2020 including the Impact of the SARS-CoV-2 Pandemic

Since the 1990s, there has been a significant increase in the number of imaging examinations as well as a related increase in the healthcare expenditure and the exposure of the population to X-rays. This study aimed to analyze the workload trends in radiology during the last decade, including the impact of COVID-19 in a single university hospital in Poland and to identify possible solutions to the challenges that radiology could face in the future. We compared the annual amount of computed tomography (CT), radiography (X-ray), and ultrasound (US) examinations performed between the years 2010 and 2020 and analyzed the changes in the number of practicing radiologists in Poland. The mean number of patients treated in our hospital was 60,727 per year. During the last decade, the number of CT and US examinations nearly doubled (from 87.4 to 155.7 and from 52.1 to 86.5 per 1000 patients in 2010 and 2020 respectively), while X-ray examinations decreased from 115.1 to 96.9 per 1000 patients. The SARS-CoV-2 pandemic did not change the workload trends as more chest examinations were performed. AI, which contributed to the COVID-19 diagnosis, could aid radiologists in the future with the growing workload by increasing the efficiency of radiology departments as well as by potentially minimizing the related costs