Periodontitis and risk for preeclampsia — a systematic review

Objectives: The aim of the study is to review systematic cohort and randomized trials on the relationship between periodontitis and preeclampsia. Periodontitis is an independent risk factor for preeclampsia (PE), and periodontal treatment could play a significant role in the prevention of this pregnancy complication. Material and methods: A total of 821 items (published until March 2019), thematically related to the relationship between periodontitis, its treatment and the incidence of preeclampsia, were collected from the databases of PubMed, Scopus, Google Scholar and the Polish Database of Medical Bibliography and analyzed. In the end, 6 cohort studies and 3 randomized controlled trials (from the years 2003–2016) were deemed eligible for the review. The main exclusion criteria were as follows: case-control and cross-sectional studies, medical and dental conditions. Results: A significant relationship between periodontitis and the risk for developing preeclampsia was demonstrated in 5 cohort trials, which was not confirmed by only 1 study. A total of 2724 pregnant women, including 195 (7.16%) with PE, were analyzed. In 3 randomized trials which assessed the impact of non-surgical treatment (scaling and root planing = SRP) on the occurrence of preeclampsia, the preventive effects of the implemented treatment was not confirmed. A total of 116 women from the group of 1825 pregnant subjects undergoing the non-surgical treatment (SRP) and 116 women from the control group of 1827 pregnant women were subsequently diagnosed with PE, which amounted to 6.30% and 6.35%, respectively. Conclusions: The cohort studies indicated that periodontitis may result in an increased risk for developing PE. A more detailed analysis regarding the impact of potential risk factors and modification of further studies (clarification of how periodontitis and preeclampsia should be defined in observations, consideration of disease severity, earlier at 12–16 weeks of gestation — implementation of the non-surgical treatment, modification and extension of the classical protocol of the non-surgical treatment of periodontal diseases, as well as conducting European studies), are necessary due to considerable discrepancies in the available literature sources (cohort and randomized observations)

Acupuncture : could it become everyday practice in oncology?

Acupuncture is a complementary and alternative medical treatment (CAM) which is increasingly used in the care of cancer patients. Traditionally derived from Chinese medicine, nowadays it is becoming a part of evidence-based oncology. The use of acupuncture in these patients has been recommended by the American Cancer Society (ACS) for the treatment of side effects associated with conventional cancer therapy and cancer-related ailments. A growing body of evidence supports the use of acupuncture in the treatment of cancer- induced pain and chemotherapy- related nausea and vomiting. Also other indications, such as xerostomia, fatigue, hot flashes, anxiety and peripheral neuropathy, are being constantly evaluated. This article summarizes the most important discoveries related to the possible usefulness of this method in contemporary oncology. Emphasis is placed on the results of randomized controlled trials with an adequate level of evidence. However, explanation of the mechanisms responsible for these effects requires confirmation in further studies with an adequate level of evidence. In future, acupuncture may become an interesting and valuable addition to conventional medicine

Medialny obraz rodziny i płci

Praca recenzowana / peer-reviewed pape

Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study

Background: Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults with familial hypercholesterolaemia were diagnosed before age 18 years via current diagnostic approaches, which are derived from observations in adults. We aimed to characterise children and adolescents with heterozygous familial hypercholesterolaemia (HeFH) and understand current approaches to the identification and management of familial hypercholesterolaemia to inform future public health strategies. Methods: For this cross-sectional study, we assessed children and adolescents younger than 18 years with a clinical or genetic diagnosis of HeFH at the time of entry into the Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, and Jan 31, 2021. Data in the registry were collected from 55 regional or national registries in 48 countries. Diagnoses relying on self-reported history of familial hypercholesterolaemia and suspected secondary hypercholesterolaemia were excluded from the registry; people with untreated LDL cholesterol (LDL-C) of at least 13·0 mmol/L were excluded from this study. Data were assessed overall and by WHO region, World Bank country income status, age, diagnostic criteria, and index-case status. The main outcome of this study was to assess current identification and management of children and adolescents with familial hypercholesterolaemia. Findings: Of 63 093 individuals in the FHSC registry, 11 848 (18·8%) were children or adolescents younger than 18 years with HeFH and were included in this study; 5756 (50·2%) of 11 476 included individuals were female and 5720 (49·8%) were male. Sex data were missing for 372 (3·1%) of 11 848 individuals. Median age at registry entry was 9·6 years (IQR 5·8-13·2). 10 099 (89·9%) of 11 235 included individuals had a final genetically confirmed diagnosis of familial hypercholesterolaemia and 1136 (10·1%) had a clinical diagnosis. Genetically confirmed diagnosis data or clinical diagnosis data were missing for 613 (5·2%) of 11 848 individuals. Genetic diagnosis was more common in children and adolescents from high-income countries (9427 [92·4%] of 10 202) than in children and adolescents from non-high-income countries (199 [48·0%] of 415). 3414 (31·6%) of 10 804 children or adolescents were index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, and cardiovascular disease were uncommon, but were more common in non-high-income countries. 7557 (72·4%) of 10 428 included children or adolescents were not taking lipid-lowering medication (LLM) and had a median LDL-C of 5·00 mmol/L (IQR 4·05-6·08). Compared with genetic diagnosis, the use of unadapted clinical criteria intended for use in adults and reliant on more extreme phenotypes could result in 50-75% of children and adolescents with familial hypercholesterolaemia not being identified. Interpretation: Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation. Where genetic testing is unavailable, increased availability and use of LDL-C measurements in the first few years of life could help reduce the current gap between prevalence and detection, enabling increased use of combination LLM to reach recommended LDL-C targets early in life

Strength Tests of Hardened Cement Slurries for Energy Piles, with the Addition of Graphite and Graphene, in Terms of Increasing the Heat Transfer Efficiency

The development of civilization, and subsequent increase in the number of new buildings, poses engineering problems which are progressively more difficult to solve, especially in the field of geotechnics and geoengineering. When designing new facilities, particular attention should be paid to environmental aspects, and thus any new facility should be a passive building, fully self-sufficient in energy. The use of load-bearing energy piles could be a solution. This article presents research on the cement slurry formulas with the addition of graphite and graphene, that can be used as a material for load-bearing piles. The proposed solution is to introduce U-tubes into the pile to exchange heat with the rock mass (the so-called energy piles). A comparison of four slurry formulas is presented: the first one consisting mainly of cement (CEM I), graphite, and water, and the remaining three with different percentages of graphene relative to the weight of dry cement. The results could contribute to the industrial application of those formulas in the future

Analysis of cases of suicide by self-immolation in the post-mortem material of the Department of Forensic Medicine in Cracow = Analiza przypadków samobójstw przez podpalenie w materiale sekcyjnym Zakładu Medycyny Sądowej w Krakowie

Cel pracy: Analiza przypadków samospaleń oraz rozmieszczenia powstałych oparzeń i ich stopnia.Materiał i metody: Do badania włączono 16 przypadków z Zakładu Medycyny Sądowej Collegium Medicum w Krakowie z lat 2000-2022, w których przyczyną śmierci było samospalenie. Po dokonaniu analizy zdjęć i protokołów sekcyjnych wykonano rysunki przedstawiające dokładne rozmieszczenie i charakter obrażeń, ustalono przybliżony procent zajętej powierzchni ciała, częstość zajęcia poszczególnych obszarów ciała, występowanie wcześniejszych chorób i zaburzeń psychicznych, w tym poprzednie próby samobójcze.Wyniki: Mężczyźni stanowili 81% ofiar. Wśród analizowanych przypadków dominują dwie grupy wiekowe - osoby w okolicach 20. roku życia oraz między 50. a 60. rokiem życia. 44% zmarłych miało poparzenia na powierzchni przekraczającej 80% całkowitej powierzchni ciała. Najczęściej zajętymi obszarami ciała były kończyny, klatka piersiowa oraz głowa i szyja. Oparzenia IV stopnia najczęściej pojawiały się w rejonie głowy i szyi, III na kończynach górnych i dolnych, oparzenia II stopnia na klatce piersiowej, zaś I na kończynach dolnych. W żadnym przypadku nie doszło do oparzenia IV stopnia pośladków. 38% badanych miało historię nadużywania substancji psychoaktywnych, 56% historię chorób psychicznych. 31% ofiar w przeszłości podejmowało próby samobójcze.Wnioski: Rozmieszczenie oparzeń w przypadkach samospaleń jest niejednorodne. Najczęściej zajętym obszarem była głowa, szyja, klatka piersiowa oraz kończyny, co spowodowane jest najprawdopodobniej oblewaniem się substancją łatwopalną przez ofiary od czubka głowy poprzez klatkę piersiową. We wszystkich przypadkach bezpośrednią przyczyną zgonu była choroba oparzeniowa, niezależnie od wielkości powierzchni ciała, jaką zajmowały oparzenia. Większość ofiar samospaleń ma historię chorób psychicznych, nadużywania substancji psychoaktywnych bądź wcześniejszych prób samobójczych

Expression and Concentration of Matrix Metalloproteinase 9 and Tissue Inhibitor of Matrix Metalloproteinases 1 in Laryngeal Squamous Cell Carcinoma

The aim of this study was to assess the expression of MMP-9 and TIMP-1 in cancerous tissue as well as in the serum and plasma concentrations of these proteins in patients with laryngeal cancer and compare the results to the inflammatory reaction in healthy subjects. Twenty-seven patients who were diagnosed with laryngeal carcinoma and selected for total laryngectomy were included in the study group. MMP-9 and TIMP-1 expression in tissues was assessed using immunohistochemical assays. Immunoenzymatic ELISA methods were used to measure MMP-9 and TIMP-1 concentrations in serum and plasma. MMP-9 and TIMP-1 were identified in tumor cells and in the tumor stroma compartment, as well as in macroscopically healthy mucous membrane. MMP-9 expression was more significant in tumor stroma than in the perimatrix of the mucous membrane (p=0.047). TIMP-1 expression was significantly higher in the matrix and perimatrix of the mucous membrane than in cancer tissue (p=0.0093) and the tumor stroma compartment (p<0.0001). Expression of TIMP-1 was observed more frequently in tumors without infiltrated lymph nodes (p=0.009). Serum concentrations of MMP-9 and TIMP-1 as well as plasma TIMP-1 concentration were significantly higher in the study group than in the control group (p=0.0004, p=0.002, and p=0.0001, respectively). A significantly higher TIMP-1 level in plasma was found in patients with poorly differentiated tumors compared to G1 and G2 (p=0.046). MMP-9/TIMP-1 rate in serum was significantly higher in the study group than in the control group. The balance between the level of MMP-9 and TIMP-1 is disrupted in laryngeal cancer. The significant correlation between TIMP-1 expression and the presence of lymph node metastases, as well as that between TIMP-1 plasma concentration and stage of cancer histological differentiation, might indicate the importance of this molecule as a prognostic factor during carcinogenesis

Combination Testing Using a Single MSH5 Variant alongside HLA Haplotypes Improves the Sensitivity of Predicting Coeliac Disease Risk in the Polish Population.

Assessment of non-HLA variants alongside standard HLA testing was previously shown to improve the identification of potential coeliac disease (CD) patients. We intended to identify new genetic variants associated with CD in the Polish population that would improve CD risk prediction when used alongside HLA haplotype analysis. DNA samples of 336 CD and 264 unrelated healthy controls were used to create DNA pools for a genome wide association study (GWAS). GWAS findings were validated with individual HLA tag single nucleotide polymorphism (SNP) typing of 473 patients and 714 healthy controls. Association analysis using four HLA-tagging SNPs showed that, as was found in other populations, positive predicting genotypes (HLA-DQ2.5/DQ2.5, HLA-DQ2.5/DQ2.2, and HLA-DQ2.5/DQ8) were found at higher frequencies in CD patients than in healthy control individuals in the Polish population. Both CD-associated SNPs discovered by GWAS were found in the CD susceptibility region, confirming the previously-determined association of the major histocompatibility (MHC) region with CD pathogenesis. The two most significant SNPs from the GWAS were rs9272346 (HLA-dependent; localized within 1 Kb of DQA1) and rs3130484 (HLA-independent; mapped to MSH5). Specificity of CD prediction using the four HLA-tagging SNPs achieved 92.9%, but sensitivity was only 45.5%. However, when a testing combination of the HLA-tagging SNPs and the MSH5 SNP was used, specificity decreased to 80%, and sensitivity increased to 74%. This study confirmed that improvement of CD risk prediction sensitivity could be achieved by including non-HLA SNPs alongside HLA SNPs in genetic testing