Low to middle Pleistocene paleoclimatic record from the Kraków-Częstochowa Upland (Poland) based on isotopic and calcite fabrics analyses

The quality of paleoenvironmental reconstruction based on speleothem records depends on the accuracy of the used proxies and the chronology of the studied record. As far as the dating method is concerned, in most cases, the best solution is the use of the U-series method to obtain a precise chronology. However, for older periods (i.e., over 0.5 Ma), dating has become a serious challenge. Theoretically, older materials could be dated with the U-Pb dating method. However, that method re-quires a relatively high uranium content (minimum of several ppm), whereas typical speleothems from Poland (and all of Central Europe) have uranium concentrations below 0.1 ppm. Because the materials in Polish caves are problematic, we applied oxygen isotope stratigraphy (OIS) as a tool for speleothem dating. By using OIS as an alternative tool to create a chronology of our flowstone, it was found that the studied flowstone crystallized from 975 to 470 ka with three major discontinuities, so obtained isotopic record can be correlated with oxygen isotopic stages from MIS 24 to MIS 12. The observed isotopic variability was also consistent and confirmed with the petrographic observations of the flowstone

No valley deepening of the Tatra Mountains (Western Carpathians) during the past 300 ka

Wet-based mountain glaciers are efficient agents of erosion, which leads to the assumption that each glacial episode results in successive valley deepening. The tendency of subsequent glaciations to obscure evidence of previous events makes it difficult to study the work done by past glacial episodes. Epiphreatic and paleophreatic caves that developed at or under the water table and dried out in response to valley deepening can serve as recorders of the valley incision history. U-series data from speleothems in the cave networks at the base of the present-day valleys in the Tatra Mountains (Western Carpathians) consistently yield the oldest ages of ca. 325 ka. While speleothem ages are typically phreatic-vadose transition minimum ages, they nonetheless unequivocally demonstrate that neither glacial valley deepening nor fluvial incision occurred over the past 300 ka, unlike the successive valley deepening over the same period in the adjacent Alps

Dual therapy based on raltegravir and boosted protease inhibitors : the experience of Polish centers

Introduction: The aim of the study was to present the experience of Polish centers regarding dual therapy based on the integrase inhibitor raltegravir (RAL) and ritonavir-boosted protease inhibitors (PI/r) for treating treatment-naïve and -experienced HIV-infected patients. Material and methods: The paper concerns a retrospective multicenter study. The medical databases of six main Polish HIV centers from January 2009 to December 2014 were analyzed for the use of combined antiretroviral treatment consisting of RAL + PI/r. This study included 126 HIV-infected patients receiving RAL + PI/r therapy, of whom 17 patients were treatment-naive and 109 patients were treatment-experienced. Results: In treatment-experienced patients, the most common reasons for the introduction of a RAL + PI/r regimen were virologic failure and impaired renal function (45 of 109 patients). In the treatment-naïve group kidney disease was the cause of the RAL + PI/r regimen in 3 of 17 participants. In treatment-experienced patients, 80% of individuals still were on RAL + PI/r treatment after 12 months, 65% after 24 months and 53% of subjects after 60 months. In both groups, the simplification of the antiretroviral regimen was the most common reason for discontinuation of RAL + PI/r based therapy. Conclusions: In antiretroviral-experienced patients the dual therapy based on RAL + PI/s is safe and effective. In antiretroviral-naïve patients the RAL + PI/r regimen is rarely used in Poland

Real-life study of dual therapy based on dolutegravir and ritonavir-boosted darunavir in HIV-1-infected treatment-experienced patients

<div><p>Background</p><p>Dual therapy based on dolutegravir and ritonavir-boosted darunavir (DTG/DRV/r) is a combination of well-known drugs with a high genetic barrier to HIV resistance.</p><p>Method</p><p>A retrospective analysis of all HIV-1 infected treatment-experienced patients who switched to DTG/DRV/r from May 2014 till March 2017 in 4 Polish centres–results of a 48-week treatment.</p><p>Results</p><p>The study group consisted of 59 men and 17 women. Median baseline parameters were: age– 42.7 years, CD4 cells count– 560.5 cells/μl, CD4 cells nadir– 150 cells/μl, <i>number</i> of prior antiretroviral <i>regimens–</i> 3. The introduction of dual therapy was primarily due to virologic failure (30 patients), adverse events on previous regimens (17 patients) and therapy simplification (27 patients). At week 48 the treatment <i>was continued</i> in 70/76 of patients and the median CD4 cells count increased from 560.5 to 641.0 cells/μl. The therapy was discontinued in six patients (1 –virologic failure, 1 –decrease of estimated glomerular filtration rate (eGFR), 1 –myalgia, 3 –lost to follow-up). At week 48 six patients had detectable viremia, but only in one patient viremia was higher than 200 copies/ml. At week 48 the level of serum total cholesterol of the investigated subjects was statistically significantly higher than at the moment of dual therapy introduction (185.8 mg/dl vs. 174.8 mg/dl- p<0.05). However, in patients previously not treated with TDF, there were no changes in lipid parameters during therapy. <i>Proteinuria</i> was observed in 13.2% of patients before the switch to dual therapy and in 7.1% of patients at week 48.</p><p>Conclusions</p><p>The investigated dual therapy was effective and safe. The observed increase in lipid parameters only concerned the patients who had used a TDF-based regimen prior to analysed dual treatment.</p></div

Lipodystrophy syndrome in HIV-infected patients -a cohort study in Lower Silesia, Poland

Abstract Introduction: Human immunodeficiency virus (HIV)-associated lipodystrophy syndrome (LS) is defined as a redistribution of adipose tissue, metabolic and endocrine abnormalities, resulting from combined antiretroviral therapy (cART). Aim of this study was to evaluate LS in HIV-infected patients from Lower Silesia, Poland

Meeting the WHO 90% target : antiretroviral treatment efficacy in Poland is associated with baseline clinical patient characteristics

Introduction: Modern combined antiretroviral therapies (cART) allow to effectively suppress HIV-1 viral load, with the 90% virologic success rate, meeting the WHO target in most clinical settings. The aim of this study was to analyse antiretroviral treatment efficacy in Poland and to identify variables associated with virologic suppression. Methods: Cross-sectional data on 5152 (56.92% of the countrywide treated at the time-point of analysis) patients on cART for more than six months with at least one HIV-RNA measurement in 2016 were collected from 14 Polish centres. Patients’ characteristics and treatment type-based outcomes were analysed for the virologic suppression thresholds of <50 and <200 HIV-RNA copies/ml. CART was categorized into two nucleos(t)ide (2NRTI) plus non-nucleoside reverse transcriptase (NNRTI) inhibitors, 2NRTI plus protease (PI) inhibitor, 2NRTI plus integrase (InI) inhibitor, nucleos(t)ide sparing PI/r+InI and three drug class regimens. For statistics Chi-square and U-Mann Whitney tests and adjusted multivariate logistic regression models were used. Results: Virologic suppression rates of <50 copies/mL were observed in 4672 (90.68%) and <200 copies/mL in 4934 (95.77%) individuals. In univariate analyses, for the suppression threshold <50 copies/mL higher efficacy was noted for 2NRTI+NNRTI-based combinations (94.73%) compared to 2NRTI+PI (89.93%), 2NRTI+InI (90.61%), nucleos(t)ide sparing PI/r+InI (82.02%) and three drug class regimens (74.49%) (p < 0.0001), with less pronounced but significant differences for the threshold of 200 copies/mL [2NRTI+NNRTI-97.61%, 2NRTI+PI-95.27%, 2NRTI+InI-96.61%, PI/r+InI- 95.51% and 86.22% for three drug class cART) (p < 0.0001). However, in multivariate model, virologic efficacy for viral load <50 copies/mL was similar across treatment groups with significant influence by history of AIDS [OR:1.48 (95%CI:1.01–2.17) if AIDS diagnosed, p = 0.046], viral load < 5 log copies/mL at care entry [OR:1.47 (95%CI:1.08–2.01), p = 0.016], baseline lymphocyte CD4 count ≥200 cells/µL [OR:1.72 (95%CI:1.04–2.78), p = 0.034] and negative HCV serology [OR:1.97 (95%CI:1.29–2.94), p = 0.002]. For viral load threshold <200 copies/mL higher likelihood of virologic success was only associated with baseline lymphocyte CD4 count ≥200 cells/µL [OR:2.08 (95%CI:1.01–4.35), p = 0.049] and negative HCV status [OR:2.84 (95%CI:1.52–5.26), p = 0.001]. Conclusions: Proportion of virologically suppressed patients is in line with WHO treatment target confirming successful application of antiretroviral treatment strategy in Poland. Virological suppression rates depend on baseline patient characteristics, which should guide individualized antiretroviral tre0atment decisions

Porównanie odporności na uderzenia dzianej protezy wykonanej z polipropylenu oraz cementu akrylowego na bazie poli(metakrylanu metylu)

The aim of the study was to compare the physical and mechanical properties of known prostheses for cranioplasty: knitted Codubix based on polypropylene and Modela-cryl resin based on PMMA. It was expected that the study would allow to check whether it is possible to combine their properties, which should enable the preparation of a new material with properties combining the best features of both components. Physico-chemical and mechanical properties were evaluated. It was found that the two materials meet the requirements for chemical purity, ensuring the safety of their use. Regarding the mechanical properties, the energy of impact diffusion for two types of prostheses was determined applying the Drop Tower technique. The polymerisation heat of Modela-cryl resin was determined in real time using the DSC technique.Celem pracy było porównanie właściwości fizycznych i mechanicznych znanych protez do kranioplastyki: dzianej Codubix na bazie polipropylenu i żywicy Modela-cryl na bazie PMMA. Oczekiwano, że badanie pozwoli sprawdzić, czy możliwe jest połączenie ich właściwości, co powinno pozwolić na przygotowanie nowego materiału o właściwościach łączących najlepsze cechy obu komponentów. Oceniono właściwości fizykochemiczne i mechaniczne. Stwierdzono, że oba materiały spełniają wymagania czystości chemicznej, zapewniając bezpieczeństwo ich stosowania. Jeśli chodzi o właściwości mechaniczne, określono energię dyfuzji uderzeniowej dla dwóch typów protez przy użyciu techniki Drop Tower. Określono ciepło polimeryzacji żywicy Modela-cryl w czasie rzeczywistym za pomocą techniki DSC