Extensive Cutaneous Ulceration of the Scalp – Unknown Disease Entity or Dermatitis Artefacta?

Psychological disturbances and emotional stress events may elicit a wide spectrum of skin disturbances which are classified as dermatitis artefacta. This diagnosis should be taken into consideration when symptoms coexist in a bizarre pattern or indicate at least several distinct skin pathologies while laboratory tests remain inconclusive. We present a case of dermatitis artefacta which produced very extensive loss of the scalp. Our intention was to show difficulties in diagnostic management of this recurrent and complex psychiatric disorder which may inconvenience clinicians. Neither laboratory tests (including bacteriology) nor X-ray of the skull identified any significant pathology. Although histopathology excluded skin malignancy, it showed an unspecific pattern not attributable to the most probable skin conditions like pyoderma gangrenosum or infection. Psychiatric consultation was inconclusive. Despite undetermined diagnosis, the patient was eligible for reconstructive surgery, which restored his scalp coverage. Different skin conditions may share very similar spectra of clinical symptoms, and even deep medical investigation does not always enable us to define the observed condition. However, both laboratory and imaging tests are necessary to exclude infections or potential malignancies before the diagnosis of dermatitis artefacta is established, whereas psychiatric consultation may or may not identify mental issues

Extensive Cutaneous Ulceration of the Scalp – Unknown Disease Entity or Dermatitis Artefacta?

Psychological disturbances and emotional stress events may elicit a wide spectrum of skin disturbances which are classified as dermatitis artefacta. This diagnosis should be taken into consideration when symptoms coexist in a bizarre pattern or indicate at least several distinct skin pathologies while laboratory tests remain inconclusive. We present a case of dermatitis artefacta which produced very extensive loss of the scalp. Our intention was to show difficulties in diagnostic management of this recurrent and complex psychiatric disorder which may inconvenience clinicians. Neither laboratory tests (including bacteriology) nor X-ray of the skull identified any significant pathology. Although histopathology excluded skin malignancy, it showed an unspecific pattern not attributable to the most probable skin conditions like pyoderma gangrenosum or infection. Psychiatric consultation was inconclusive. Despite undetermined diagnosis, the patient was eligible for reconstructive surgery, which restored his scalp coverage. Different skin conditions may share very similar spectra of clinical symptoms, and even deep medical investigation does not always enable us to define the observed condition. However, both laboratory and imaging tests are necessary to exclude infections or potential malignancies before the diagnosis of dermatitis artefacta is established, whereas psychiatric consultation may or may not identify mental issues

The Role of Complement Activating Collectins and Associated Serine Proteases in Patients With Hematological Malignancies, Receiving High-Dose Chemotherapy, and Autologous Hematopoietic Stem Cell Transplantations (Auto-HSCT)

We conducted a prospective study of 312 patients (194 with multiple myeloma, 118 with lymphomas) receiving high-dose conditioning chemotherapy and autologous hematopoietic stem cell transplantation (auto-HSCT). Polymorphisms of MBL2 and MASP2 genes were investigated and serial measurements of serum concentrations of mannose-binding lectin (MBL), CL-LK collectin and MASP-2 as well as activities of MBL-MASP-1 and MBL-MASP-2 complex were made. Serum samples were taken before conditioning chemotherapy, before HSCT and once weekly after (totally 4-5 samples); in minority of subjects also 1 and/or 3 months post transplantation. The results were compared with data from 267 healthy controls and analyzed in relation to clinical data to explore possible associations with cancer and with chemotherapy-induced medical complications. We found a higher frequency of MBL deficiency-associated genotypes (LXA/O or O/O) among multiple myeloma patients compared with controls. It was however not associated with hospital infections or post-HSCT recovery of leukocytes, but seemed to be associated with the most severe infections during follow-up. Paradoxically, high MBL serum levels were a risk factor for prolonged fever and some infections. The first possible association of MBL2 gene 3′-untranslated region polymorphism with cancer (lymphoma) in Caucasians was noted. Heterozygosity for MASP2 gene +359 A>G mutation was relatively frequent in lymphoma patients who experienced bacteremia during hospital stay. The median concentration of CL-LK was higher in myeloma patients compared with healthy subjects. Chemotherapy induced marked increases in serum MBL and MASP-2 concentrations, prolonged for several weeks and relatively slighter decline in CL-LK level within 1 week. Conflicting findings on the influence of MBL on infections following chemotherapy of myeloma and lymphoma have been reported. Here we found no evidence for an association between MBL deficiency and infection during the short period of neutropenia following conditioning treatment before HSCT. However, we noted a possible protective effect of MBL during follow-up, and suspected that to be fully effective when able to act in combination with phagocytic cells after their recovery

The most common damage to the foundations of poles of extra high voltage power lines and the methods of their repair

The paper consists of the discussion of issues related to the durability of foundations of extra high voltage (EHV) power line poles and possibilities of their renovation. The research part is the diagnostics of selected foundations of the EHV line poles (400 kV) Wielopole–Noszowice. During the on-site inspection, it was found that there are chipping and small surface defects, and in some cases losses of the reinforcement cover without visible pits. Based on the degree of damage, the scope of non-structural repairs and anti-corrosive protection was determined, presenting the next stages of their implementation

Role of Vitamin C in Osteoporosis Development and Treatment—A Literature Review

Osteoporosis and associated low energy fractures are a significant clinical problem, especially in the elderly population. The occurrence of a hip fracture is associated with significant mortality and a high risk of disability. For this, apart from the treatment of osteoporosis, effective prevention of both the development of the disease and related fractures is extremely important. One aspect of osteoporosis prevention is proper dietary calcium intake and normal vitamin D3 levels. However, there is some evidence for a potential role of vitamin C in osteoporosis and fracture prevention, too. This review aims to summarize the current knowledge about the role of vitamin C in osteoporosis development, prevention and treatment. The PubMed/Medline search on the role of vitamin C in bone metabolism database was performed for articles between 2000 and May 2020. Reports from in vitro and animal studies seem promising. Epidemiological studies also indicate the positive effect of high vitamin C content in the daily diet on bone mineral density. Despite promising observations, there are still few observational and intervention studies and their results do not allow for unequivocal determination of the benefits of high daily intake of vitamin C or its long-term supplementation

Role of Vitamin C in Prophylaxis and Treatment of Gout—A Literature Review

Gout, known as “the disease of the kings”, is the most frequent type of arthritis. It results from sustained hyperuricemia that leads to monosodium urate crystal deposition in joint structures and soft tissue. Environmental factors such as diet affect the incidence of gout; there is a known relationship between the occurrence of an acute attack of gout and the consumption of alcohol and meat; and a low purine diet is a widely recognized nonpharmacological method of supplementing the treatment and preventing recurrence of arthritis. This review aims to summarize the current knowledge about the role of vitamin C in prevention and treatment of gout. A PubMed/Medline database search on the role of vitamin C in purine metabolism was done. Reports from in vitro and animal studies seem to be promising and to allow explanation of the physiological relationship between vitamin C and uric acid. Most epidemiological studies indicate a significant correlation between high vitamin C intake and lower serum uric acid levels. Despite promising observations, there are few observational and interventional studies, and their results do not clearly define the benefits of a high daily intake of vitamin C in preventing the development and recurrence of gout

Peptyd natriuretyczny NT-proBNP jako wskaźnik przeciążenia układu sercowo-naczyniowego u kobiet w ciąży z nadwagą i otyłością

Wstęp. Nadwaga i otyłość to coraz powszechniejsze problemy wśród kobiet w ciąży. Otyłość często skorelowanajest z przeciążeniem układu sercowo-naczyniowego, co może mieć odzwierciedlenie w zmienionym stężeniu biomarkerówsercowych.Materiał i metody. W prezentowanym badaniu oceniono stężenie w surowicy N-końcowego fragmentu (pro) peptydunatriuretycznego typu B (NT-proBNP, N-terminal pro B-type natriuretic peptide) w grupach kobiet ciężarnych: z prawidłowąmasą ciała, z nadwagą i z otyłością, a za pomocą metod statystycznych porównano różnice w stężeniachtego markera między grupami.Wyniki. Najwyższe stężenia peptydu natriuretycznego obserwowano u pacjentek z prawidłową wartością BMI,natomiast w surowicy krwi ciężarnych z nadwagą i otyłością obserwowano niższe stężenia NT-proBNP.Wnioski. Kobiety powinny mieć świadomość negatywnego wpływu nadmiernej ilości tkanki tłuszczowej oraz nadmiernegoprzyrostu masy ciała na rozwój płodu i jego wzrastanie oraz negatywnych konsekwencji zdrowotnych dlanich samych. Stężenie NT-proBNP u pacjentek z nieprawidłowo wysokimi wartościami BMI jest trudne do interpretacji,dlatego konieczne jest prowadzenie dalszych badań w celu wykrycia miarodajnego markera oceniającegowydolność układu krążenia u ciężarnych zarówno z prawidłowymi wartościami BMI, jak i nieprawidłowymi

Increased Sensitivity of PBMCs Isolated from Patients with Rheumatoid Arthritis to DNA Damaging Agents Is Connected with Inefficient DNA Repair

Rheumatoid arthritis (RA) is a systemic, inflammatory disease of the joints and surrounding tissues. RA manifests itself with severe joint pain, articular inflammation, and oxidative stress. RA is associated with certain types of cancer. We have assumed that RA patients’ increased susceptibility to cancer may be linked with genomic instability induced by impaired DNA repair and sensitivity to DNA damaging agents. The aim of this work was to analyze the sensitivity of peripheral blood mononuclear cells (PBMCs) isolated from RA patients to DNA damaging agents: tert-butyl hydroperoxide (TBH), bleomycin, ultraviolet (UV) radiation, and methyl methanesulfonate (MMS) and calculate the repair efficiency. TBH induce oxidative DNA lesions repaired mainly by base excision repair (BER). Bleomycin induced mainly DNA double-strand breaks repaired by non-homologous end joining (NHEJ) and homologous recombination repair (HRR). We included 20 rheumatoid arthritis patients and 20 healthy controls and used an alkaline version of the comet assay with modification to measure sensitivity to DNA damaging agents and DNA repair efficiency. We found an increased number of DNA breaks and alkali-labile sites in the RA patients compared to those in the controls. Exposure to DNA damaging agents evoked the same increased damage in both groups, but we observed statistically higher PMBC sensitivity to TBH, MMS, bleomycin as well as UV. Examination of the repair kinetics of both groups revealed that the DNA lesions induced by TBH and bleomycin were more efficiently repaired in the controls than in the patients. These data suggest impaired DNA repair in RA patients, which may accelerate PBMC aging and/or lead to higher cancer incidence among RA patients

SNP in <i>PTPN22</i>, <i>PADI4,</i> and <i>STAT4</i> but Not <i>TRAF1</i> and <i>CD40</i> Increase the Risk of Rheumatoid Arthritis in Polish Population

Single nucleotide polymorphisms in non-HLA genes are involved in the development of rheumatoid arthritis (RA). SNPS in genes: PADI4 (rs2240340), STAT4 (rs7574865), CD40 (rs4810485), PTPN22 (rs2476601), and TRAF1 (rs3761847) have been described as risk factors for the development of autoimmune diseases, including RA. This study aimed to assess the prevalence of polymorphisms of these genes in the Polish population of patients with rheumatoid arthritis as compared to healthy controls. 324 subjects were included in the study: 153 healthy subjects and 181 patients from the Department of Rheumatology, Medical University of Lodz who fulfilled the criteria of rheumatoid arthritis diagnosis. Genotypes were determined by Taqman SNP Genotyping Assay. rs2476601 (G/A, OR = 2.16, CI = 1.27–3.66; A/A, OR = 10.35, CI = 1.27–84.21), rs2240340 (C/T, OR = 4.35, CI = 2.55–7.42; T/T, OR = 2.80, CI = 1.43–4.10) and rs7574865 (G/T, OR = 1.97, CI = 1.21–3.21; T/T, OR = 3.33, CI = 1.01–11.02) were associated with RA in the Polish population. Rs4810485 was also associated with RA, however after Bonferroni’s correction was statistically insignificant. We also found an association between minor alleles of rs2476601, rs2240340, and rs7574865 and RA (OR = 2.32, CI = 1.47–3.66; OR = 2.335, CI = 1.64–3.31; OR = 1.88, CI = 1.27–2.79, respectively). Multilocus analysis revealed an association between CGGGT and rare (below 0.02 frequency) haplotypes (OR = 12.28, CI = 2.65–56.91; OR = 3.23, CI = 1.63–6.39). In the Polish population, polymorphisms of the PADI4, PTPN22, and STAT4 genes have been detected, which are also known risk factors for RA in various other populations