Common use of preservatives as a current problem in maintaining normophosphatemia in haemodialysed patients

Niewłaściwy sposób odżywiania wśród pacjentów z przewlekłą chorobą nerek wciąż jest poważnym problemem, skutkującym pogorszeniem stanu klinicznego, zmniejszoną jakością życia, a nawet zwiększoną śmiertelnością. Prawidłowe wyrównanie gospodarki wapniowo-fosforanowej stanowi wynik stosowania przez chorego zalecanej diety oraz prawidłowego przyjmowania leków wiążących fosfor w przewodzie pokarmowym. Jednak mimo prawidłowo prowadzonej edukacji zdrowotnej zalecenia dietetyczne i farmakologiczne są często lekceważone przez chorych. Problem ten występuje w wielu ośrodkach dializacyjnych, wskazując na konieczność poddawania permanentnej edukacji każdego pacjenta, który tego wymaga. Znaczącym i stale aktualnym problemem, którego świadomość powinni mieć wszyscy chorzy, jest fosfor nieorganiczny, stosowany powszechnie do konserwowania żywności i wchłaniany w całości przez ludzki organizm. Głównym celem niniejszego artykułu jest zwrócenie uwagi na żywność nasyconą substancjami fosforogennymi, które utrudniają utrzymanie normofosfatemii pomimo zaangażowania i dobrej współpracy ze strony chorego w efekcie edukacji.Improper nutrition among patients with chronic kidney disease is still a serious problem which results in deterioration of the clinical condition, lower quality of life and even higher mortality rate. Correct control of calcium and phosphate metabolism is the effect of following by the patient the recommended diet and proper taking of medicines fixing phosphorus in the alimentary canal. However, despite adequate health education many patients often disregard dietary and pharmacological recommendations. Such a problem exists in many dialysis centres, which shows the necessity of permanent education of each patient who requires it. A significant and still relevant problem that should be recognised by all patients is inorganic phosphorus, which is commonly used in food preservation and absorbed by the human organism in full. The main objective of this article is to point out culinary areas rich in phosphorus substances which make it difficult to maintain normophosphatemia despite the patient’s commitment and good cooperation in educational effect

Od pierwotnej niedomykalności zastawki trójdzielnej do arytmogennej kardiomiopatii prawej komory

Since arrhythmogenic right ventricular dysplasia is still an under-recognised clinical entity, its ‘deceitful’ course requires alertness of physicians, and — in particular — awareness of its less typical manifestations. Therefore, we present a case report of a 52-year-old male subject with signs and symptoms of right ventricular heart failure and marked tricuspid regurgitation

POTENTIAL GENETIC AGENT BFL1 FOR TARGETED THERAPY IN CHRONIC LYMPHOCYTIC LEUKEMIA

Background: Many prognostic factors have been identified in chronic lymphocytic leukemia (CLL) but new ones are still desired. The biological characterization of CLL is now being translated into novel treatment strategies. One new prognostic factor, and therapeutic target, may be BFL1. It is both a serum and a molecular marker that contributes to the progression of CLL and its resistance to chemotherapy. The aim of this study was to evaluate the prognostic value of BFL1 and to assess its correlation with other known prognostic markers in CLL for the cladribine and cyclophosphamide regimen (CC). Methods: qPCR TaqMan® Low Density Array was used for gene expression measurements. Assessment of CD38, ZAP70 and BFL-1 proteins expression was done by means of flow cytometry. Serum TK activity was measured by immunoassay. Results: Protein BFL1 expression was found to be significantly higher in CLL patients than healthy volunteers (p=0.001). Moreover its level was significantly higher in patients with no response (NR) to CC therapy (p=0.009). The expression of BFL1 was considerably down regulated during CC treatment and BFL1 mRNA levels were inversely correlated with apoptotic response. In addition, protein BFL1 expression was found to be similar to thymidine kinase (TK) concentration regarding treatment response. As far as other markers are concerned, a positive correlation was identified between BFL1 and TK (r=0.52, p=0.01). Conclusions: Our findings suggest that BFL1 contributes to chemoresistance and may be a co-existing prognostic factor in CLL in the future

Targeted prevention in primary care aimed at lifestyle-related diseases:a study protocol for a non-randomised pilot study

Background: The consequences of lifestyle-related disease represent a major burden for the individual as well as for society at large. Individual preventive health checks to the general population have been suggested as a mean to reduce the burden of lifestyle-related diseases, though with mixed evidence on effectiveness. Several systematic reviews, on the other hand, suggest that health checks targeting people at high risk of chronic lifestyle-related diseases may be more effective. The evidence is however very limited. To effectively target people at high risk of lifestyle-related disease, there is a substantial need to advance and implement evidence-based health strategies and interventions that facilitate the identification and management of people at high risk. This paper reports on a non-randomized pilot study carried out to test the acceptability, feasibility and short-term effects of a healthcare intervention in primary care designed to systematically identify persons at risk of developing lifestyle-related disease or who engage in health-risk behavior, and provide targeted and coherent preventive services to these individuals. Methods: The intervention took place over a three-month period from September 2016 to December 2016. Taking a two-pronged approach, the design included both a joint and a targeted intervention. The former was directed at the entire population, while the latter specifically focused on patients at high risk of a lifestyle-related disease and/or who engage in health-risk behavior. The intervention was facilitated by a digital support system. The evaluation of the pilot will comprise both quantitative and qualitative research methods. All outcome measures are based on validated instruments and aim to provide results pertaining to intervention acceptability, feasibility, and short-term effects. Discussion: This pilot study will provide a solid empirical base from which to plan and implement a full-scale randomized study with the central aim of determining the efficacy of a preventive health intervention. Trial registration: Registered at Clinical Trial Gov (Unique Protocol ID: TOFpilot2016). Registered 29 April 2016. The study adheres to the SPIRIT guidelines

Beta-Amyloid Peptides Enhance the Proliferative Response of Activated CD4+CD28+ Lymphocytes from Alzheimer Disease Patients and from Healthy Elderly

Alzheimer's disease (AD) is the most frequent form of dementia among elderly. Despite the vast amount of literature on non-specific immune mechanisms in AD there is still little information about the potential antigen-specific immune response in this pathology. It is known that early stages of AD include β-amyloid (Aβ)- reactive antibodies production and inflammatory response. Despite some evidence gathered proving cellular immune response background in AD pathology, the specific reactions of CD4+ and CD8+ cells remain unknown as the previous investigations yielded conflicting results. Here we investigated the CD4+CD28+ population of human peripheral blood T cells and showed that soluble β-amyloids alone were unable to stimulate these cells to proliferate significantly, resulting only in minor, probably antigen-specific, proliferative response. On the other hand, the exposure of in vitro pre-stimulated lymphocytes to soluble Aβ peptides significantly enhanced the proliferative response of these cells which had also lead to increased levels of TNF, IL-10 and IL-6. We also proved that Aβ peptide-enhanced proliferative response of CD4+CD28+ cells is autonomous and independent from disease status while being associated with the initial, ex vivo activation status of the CD4+ cells. In conclusion, we suggest that the effect of Aβ peptides on the immune system of AD patients does not depend on the specific reactivity to Aβ epitope(s), but is rather a consequence of an unspecific modulation of the cell cycle dynamics and cytokine production by T cells, occurring simultaneously in a huge proportion of Aβ peptide-exposed T lymphocytes and affecting the immune system performance

Pielęgniarstwo na rzecz milenijnych celów rozwoju. Cz. 2

Praca recenzowana / Peer-reviewed paperZ przyjemnością oddajemy w Państwa ręce drugi tom monografii wydanej z okazji XII Kongresu Pielęgniarek Polskich w Krakowie, w którym udział wzięło blisko 500 pielęgniarek, zaprezentowano 160 prac w 9 sesjach. Ta kolejna już publikacja świadczy o dynamicznym rozwoju badań naukowych w pielęgniarstwie. Dowodzi, że pielęgniarstwo to nie tylko zawód, ale i interdyscyplinarna nauka