Związek stosowania metforminy ze zmniejszoną zapadalnością na choroby nowotworowe u pacjentów z cukrzycą typu 2

Introduction: The objective of the study was to assess the influence of metformin on the prevalence of cancer and risk factors for the development of cancer, in patients with type 2 diabetes. Materials and methods: A total of 1063 patients, treated between October 2012 and March 2013 in the Diabetes and Endocrinology Centre in Bydgoszcz, were enrolled in the study. Only patients who were first diagnosed with diabetes and consecutively with cancer were included in the analysis. The final dataset compromised data from 1028 patients with type 2 diabetes, in whom retrospective analysis of the association between the occurrence of cancer and treatment with or without metformin was performed. Demographic data, medical history, physical assessment, diabetes history, diabetes complications, concomitant medication, and additional examination results were compared between two groups: those with cancer and those without cancer. Data were analysed using Student’s t-test, Chi-square test with Yates' continuity correction, and multiple logistic regression. Results: The most commonly observed cancer was breast cancer (24 patients; 22.5%), followed by uterine cancer (15 patients; 13.6%). Of the 75 diabetic patients with a cancer diagnosis, 18.7% were treated with metformin; of the 953 patients without cancer, 38% received metformin. Analysis of probability of cancer occurrence using Kaplan-Meier curves showed that the probability of cancer development was higher in groups of patients who were not treated with metformin (p = 0.006). Conclusions: Metformin treatment reduces the risk of cancer in type 2 diabetes patients.Wstęp: Metformina jest zalecana w profilaktyce raka u pacjentów z cukrzycą typu 2 (t2). Celem badania była ocena wpływu metforminy na częstość występowania raka i czynników ryzyka wystąpienia raka u pacjentów z cukrzycą typu 2. Materiał i metody: W badaniu wzięło udział 1063 pacjentów leczonych od października 2012 do marca 2013 w Bydgoskim Centrum Diabetologii i Endokrynologii. Do analizy włączono pacjentów, u których najpierw rozpoznano cukrzycę, a następnie raka. Ostatec­znie uzyskano dane od 1028 pacjentów z cukrzycą t2, na podstawie których przeprowadzono retrospektywną analizę związku między wystąpieniem nowotworu a stosowaniem metforminy. Grupy pacjentów z rakiem i bez raka porównano pod względem danych de­mograficznych, historii medycznej, wyników badania przedmiotowego, historii i powikłań cukrzycy, leków przyjmowanych z powodu chorób towarzyszących oraz wyników badań dodatkowych. Analizę statystyczną przeprowadzono za pomocą testu t Studenta, testu chi kwadrat z poprawką Yatesa na nieciągłość i wielokrotnej regresji logistycznej. Wyniki: Najczęściej obserwowanym rodzajem raka był rak sutka (N = 24; 22,5%), a następnie rak macicy (N = 15; 13,6%). Spośród 75 pacjentów chorujących na cukrzycę i nowotwór, 18,7% było leczonych metforminą, natomiast spośród 953 pacjentów bez nowotworu, metforminę przyjmowało 38%. Analiza prawdopodobieństwa wystąpienia raka za pomocą krzywych Kaplana-Meiera wykazała, że prawdopodobieństwo raka jest większe u pacjentów, którzy nie przyjmowali metforminy (p = 0,006). Wnioski: Metformina zmniejsza ryzyko raka u pacjentów z cukrzycą t2.

Sexual offences – selected cases

Introduction: Expert testimony on violence victims also includes victims of sexual assault. The role of an expert is to classify the injuries by their severity, as defined in art. 157, 156 or 217 of the Criminal Code pertaining to crimes against health and life. Also, the role of an expert opinion is to determine whether the injuries identified during the exam occurred at the time and under the circumstances stated in medical history. The examination of sexual assault victims is conducted by two experts: a gynecologist and a forensic physician. Most examinations are performed at different times and various medical centers. The conclusions are presented in an official report. Regardless of victim age, all sexual crimes are investigated ex officio by the Police Department and the Prosecutor’s Office. Further legal classification of criminal offenses is the task of an appropriate legal body, and the offenses are codified in accordance with the provisions of chapter XXV of the Criminal Code, articles 197 - 205. In controversial cases, i.e. when two different expert opinions appear on the same case, or if, according to the law enforcement, a medical opinion is insufficient for some reason, an appropriate expert or team of experts is appointed to resolve the problem. Objectives: To present selected cases of sexual violence victims treated at the Department of Gynecology and assessed at the Department of Forensic Medicine with reference to the challenges regarding qualification of the sustained injuries and clinical diagnoses. Material and methods: Research material included selected forensic opinions developed for law enforcement offices that involved victims of sexual violence. The expert opinions were prepared either on the basis of submitted evidence, or both, submitted evidence and examination of the victim at the Department of Forensic Medicine. Moreover, the article presents a case of a patient examined and treated at the Department of Gynecology in Poznan. Conclusions: Based on the selected cases, the authors conclude that a medico-legal expert cannot uncritically accept previous diagnoses. Moreover, every expert is given the right and obligation to verify them. The need for complete, rapid and almost simultaneous colaboration between physicians in charge of the case, forensic doctors, police officers and prosecutors was demonstrated. Lack of cooperation may give rise to different opinions, leading to unnecessary elongation of the medico-legal procedures. It was observed that time plays a crucial role if qualification of an injury is required. The obligation of medical staff to inform the law enforcement about all cases of child abuse was also emphasized

Is DNA methylation modulated by wounding-induced oxidative burst in maize?

Plants respond to environmental changes by modifying gene expression. One of the mechanisms regulating gene expression is methylation of cytosine to 5-methylcytosine (m5C) which modulates gene expression by changing chromatin structure. Methylation/demethylation processes affect genes that are controlled upon environmental stresses. Here, on account of the regulatory role of m5C, we evaluate the content of m5C in DNA from normal and wound-damaged maize leaves. Wounding leads to a transient decrease of the global DNA methylation level ca 20-30% 1 hour after the treatment followed by a return to the initial level within the next hours. Similar results were obtained using of radio-labelled nucleotides separated by Thin Layer Chromatography (TLC) or using m5C-specific Enzyme-Linked Immunosorbent Assay (ELISA). Wounding induced in maize leaves a two-step oxidative stress, an early one just after wounding and the second two hours later. It coincides with the transient changes of the cytosine methylation level. In the stress-inducible maize calcium-dependent protein kinase ZmCPK11 gene wounding transiently reduced methylation of cytosines 100 and 126 in the first exon

Beneficial Effects of Vitamins K and D3 on Redox Balance of Human Osteoblasts Cultured with Hydroxyapatite-Based Biomaterials

Hydroxyapatite-based biomaterials are commonly used in surgery to repair bone damage. However, the introduction of biomaterials into the body can cause metabolic alterations, including redox imbalance. Because vitamins D3 and K (K1, MK-4, MK-7) have pronounced osteoinductive, anti-inflammatory, and antioxidant properties, it is suggested that they may reduce the adverse effects of biomaterials. The aim of this study was to investigate the effects of vitamins D3 and K, used alone and in combination, on the redox metabolism of human osteoblasts (hFOB 1.19 cell line) cultured in the presence of hydroxyapatite-based biomaterials (Maxgraft, Cerabone, Apatos, and Gen-Os). Culturing of the osteoblasts in the presence of hydroxyapatite-based biomaterials resulted in oxidative stress manifested by increased production of reactive oxygen species and decrease of glutathione level and glutathione peroxidase activity. Such redox imbalance leads to lipid peroxidation manifested by an increase of 4-hydroxynonenal level, which is known to influence the growth of bone cells. Vitamins D3 and K were shown to help maintain redox balance and prevent lipid peroxidation in osteoblasts cultured with hydroxyapatite-based biomaterials. The strongest effect was observed for the combination of vitamin D3 and MK-7. Moreover, vitamins promoted growth of the osteoblasts, manifested by increased DNA biosynthesis. Therefore, it is suggested that the use of vitamins D3 and K may protect redox balance and support the growth of osteoblasts affected by hydroxyapatite-based biomaterials

Genome-wide analysis and expression profiling of calcium-dependent protein kinases in potato (Solanum tuberosum)

Calcium-dependent protein kinases (CDPKs or CPKs), unique to plants and some protists, are involved in growth and developmental processes as well as in defence against diverse environmental stresses. CDPKs are encoded by multi-gene families. Despite extensive studies of the CDPKs in many species, information about the evolutionary history and expression patterns of the CDPK family in the staple crop potato (Solanum tuberosum) remains poorly known. In this study, we performed bioinformatics analysis of the potato whole genome sequence and identified 23 potential CDPK genes. These genes are located in eleven, of twelve, potato chromosomes. Based on the phylogenetic tree and gene structures, the CDPKs were divided into four subfamilies. To determine their expression, reverse transcription quantitative polymerase chain reaction (RT-qPCR) analysis was carried out for the CDPK genes in different organs of potato such as young and mature leaves, stems, young shoots, roots, stolons, swollen stolons, flowers and tubers. The CDPKs were expressed in all the organs analysed, but their expression patterns varied greatly. The expression of some CDPKs was strongly organ specific, for example StCPK13 and StCPK18 was found only/ mostly in flowers. In Solanum genotypes differing in resistance to Phytophthora infestans, the expression and activity of CDPKs increased in response to a P. infestans elicitor with different kinetics and intensity. The expression levels and activity of the CDPKs correlated positively with the level of the resistance. Our results support earlier suggestion that CDPKs are involved in potato organ development and defence against stresses. We provide new information about the CDPK gene family in the potato and a perspective on its evolutionary history and biological roles of the individual kinases

Expression of maize Calcium-Dependent Protein Kinase (ZmCPK11) improves salt tolerance in transgenic Arabidopsis plants by regulating sodium and potassium homeostasis and stabilizing photosystem II

In plants, CALCIUM-DEPENDENT PROTEIN KINASES (CDPKs/CPKs) are involved in calcium signaling in response to endogenous and environmental stimuli. Here, we report that ZmCPK11, one of maize CDPKs, participates in salt stress response and tolerance. Salt stress induced expression and upregulated the activity of ZmCPK11 in maize roots and leaves. Activation of ZmCPK11 upon salt stress was also observed in roots and leaves of transgenic Arabidopsis plants expressing ZmCPK11. The transgenic plants showed a long-root phenotype under control conditions and a short-root phenotype under NaCl, abscisic acid (ABA) or jasmonic acid (JA) treatment. Analysis of ABA and JA content in roots indicated that ZmCPK11 can mediate root growth by regulating the levels of these phytohormones. Moreover, 4-week-old transgenic plants were more tolerant to salinity than the wild-type plants. Their leaves were less chlorotic and showed weaker symptoms of senescence accompanied by higher chlorophyll content and higher quantum efficiency of photosystem II. The expression of Na+/K+ transporters (HKT1, SOS1 and NHX1) and transcription factors (CBF1, CBF2, CBF3, ZAT6 and ZAT10) with known links to salinity tolerance was upregulated in roots of the transgenic plants upon salt stress. Furthermore, the transgenic plants accumulated less Na+ in roots and leaves under salinity, and showed a higher K+/Na+ ratio in leaves. These results show that the improved salt tolerance in ZmCPK11-transgenic plants could be due to an upregulation of genes involved in the maintenance of intracellular Na+ and K+ homeostasis and a protection of photosystem II against damage

The evaluation of the level of knowledge of nurses participating in the Regional Program of Workshops for Diabetic Education — initial report

Wstęp. W systemie opieki diabetologicznej w Polsceodpowiedzialność za edukację pacjenta spoczywagłównie na pielęgniarkach. Problemem jest brakszkoleń dostępnych dla większego grona pielęgniarek,które w swojej codziennej praktyce mają stycznośćz pacjentami diabetologicznymi. Celem pracy była analiza poziomu wiedzy pielęgniarek z zakresu diabetologiiuczestniczących w Regionalnym ProgramieWarsztatów Edukacji Diabetologicznej.Materiał i metody. Badaniem objęto 272 pielęgniarkiz województwa kujawsko-pomorskiego, które wzięłyudział w Warsztatach Edukacji Diabetologicznej. Wiedzępielęgniarek przed szkoleniem i po nim ocenianona podstawie identycznego testu diagnostycznegozłożonego z 12 pytań, dotyczącego tematyki poruszanejw czasie warsztatów.Wyniki. Po określeniu granicy zdawalności testu na 60%poprawnych odpowiedzi wykazano, że początkowy testzdało 10% pielęgniarek z oddziałów szpitalnych (grupa A)oraz 18% pielęgniarek pracujących w placówkach podstawowejopieki zdrowotnej (grupa B). Końcowy testzaś zdało 96% pielęgniarek z grupy A oraz 93% pielęgniarekz grupy B. Średnia punktacja uzyskana w teściepoczątkowym przez pielęgniarki grupy A i grupy B się nieróżniła (4,88 ± 2,04 vs 4,67 ± 2,3 punktów; p = 0,46),natomiast w teście końcowym była istotnie wyższaw grupie A w porównaniu z grupą B (10,3 ± 1,26 vs9,41 ± 1,54 punktów, p < 0,0001).Wnioski. Przed warsztatami znajomość zagadnieńz zakresu diabetologii była w obu grupach pielęgniarekniedostateczna. Warsztaty Edukacji Diabetologicznejpodniosły poziom wiedzy obu grup pielęgniarek.Dlatego też istnieje potrzeba prowadzenia szkoleńz zakresu diabetologii dla pielęgniarek.Introduction. In the Polish health care system, responsibilityfor the education of diabetic patients lies solelyon unspecialised nurses. A signifi cant problem is thelack of courses available to those nurses, who havecontact with diabetic patients in their daily practice.The aim of this study was to evaluate the nurses’ knowledgeconcerning diabetes.Material and methods. The study involved 272 nurses,who participated in the The Regional Program of Workshopsfor Diabetic Education. The level of knowledgewas evaluated before and after the workshops via thetest consisting of 12 questions.Results. After determining the passing percentage ofthe test as 60%, only 10% in group A — nurses workingin the clinics — and 18% in group B — nurses workingin the outpatients departments — passed the initialtest. The fi nal test was passed by 96% and 93% ofnurses, respectively. The average scores obtained inthe initial test by group A and group B didn’t differ(4.88 ± 2.04 vs 4.67 ± 2.3 points, p = 0.46), while inthe fi nal test it was signifi cantly higher in group A comparedwith group B (10.3 ± 1.26 vs 9.41 ± 1.54 points,p < 0.0001).Conclusions. Nurses working in outpatients departments,as well as nurses working in hospitals, didnot present a satisfactory level of knowledge aboutdiabetology. The Workshops for Diabetic Educationincreased the level of knowledge of both groups. Thereis a need for better education for nurses in the fi eld ofdiabetology

Outcome of refractory and relapsed acute myeloid leukemia in children treated during 2005-2011 : experience of the Polish Pediatric Leukemia/Lymphoma Study Group (PPLLSG)

AIM OF THE STUDY: Recent studies showed relatively better outcome for children with refractory (refAML) and relapsed acute myeloid leukemia (relAML). Treatment of these patients has not been unified within Polish Pediatric Leukemia/Lymphoma Study Group (PPLLSG) so far. The goal of this study is to analyze the results of this therapy performed between 2005–2011. MATERIAL AND METHODS: The outcome data of 16 patients with refAML and 62 with relAML were analyzed retrospectively. Reinduction was usually based on idarubicine, fludarabine and cytarabine with allogenic hematopoietic stem cell transplant (alloHSCT) in 5 refAML and 30 relAML children. RESULTS: Seventy seven percent relAML patients entered second complete remission (CR2). Five-year OS and disease-free survival (DFS) were estimated at 16% and 30%. The outcome for patients after alloHSCT in CR2 (63%) was better than that of those not transplanted (36%) with 5-year OS of 34% vs. 2-year of 7% and 5-year DFS of 40% vs. 12.5%. Second complete remission achievement and alloHSCT were the most significant predictors of better prognosis (p = 0.000 and p = 0.024). The outcome of refAML children was significantly worse than relAML with first remission (CR1) rate of 33%, OS and DFS of 25% at 3 years and 53% at 2 years, respectively. All survivors of refAML were treated with alloHSCT after CR1. CONCLUSIONS: The uniform reinduction regimen of the documented efficacy and subsequent alloHSCT in remission is needed to improve the outcome for ref/relAML children treated within PPLLSG. The focus should be on the future risk-directed both front and second line AML therapy