Dietary intake of antioxidants and fats in the context of coronary heart disease prevention among elderly people

Introduction Some literature data indicate that the proper intake of exogenic antioxidants from food and the proper intake of fats can offer significant protection against coronary heart disease. Objectives The estimation of total antioxidant capacity of food intake on the basis of Dietary Antioxidant Index (DAI), together with an assessment of the contribution of particular food products in DAI, and the evaluation of consumption of all dietary fats and frequency of consumption of products that are a source of fats among elderly people in Krakow, Poland. Material and Methods 143 persons (73 women and 70 men) aged 65–80 were studied. None of them was under specialist medical control, including cardiological control. DAI was investigated on the basis of the Food Frequency Questionnaire (FFQ) which included 145 food items. DAI was measured using the method by Benzi and expressed as FRAP (the ability to reduce Fe 3+ to Fe 2+ , measured in mMol/l). The daily intake of fats was estimated using the 24-h nutritional recall. The frequency of fats consumption was estimated with the usage of FFQ. For statistical analysis, χ2 test was used. Results The mean value of DAI of all studied persons was 34.27 + 11.72 mMol/l. The largest percentage of those studied had FRAP values in the range 25–35 mMol/l. The highest contribution in the total DAI value was found in fruit (36.2%), grains and cereal-based products (23.6%), and beverages (24.0%). The consumption of vegetables was on the fourth position (7.1%). The contribution of the remaining food products was low. The consumption of total fats (about 70g/24h) and saturated fatty acids (14% of energetic value) exceeded the recommendations. The participation of mono-and polyunsaturated fatty acids in the diets was not in accordance with recommendations. The most frequently consumed fats were animal fats (sausages, butter) and cakes, but the consumption of vegetable oils, fish, nuts and seeds of oil plants was too low. Conclusions The majority of elderly people made mistakes in their nutrition. The enrichment in natural antioxidants of the diets of elderly people and the normalization of their fats consumption should become an important element of primary and secondary prophylaxis of cardiovascular disease

Study protocol for a prospective, non-controlled, multicentre clinical study to evaluate the diagnostic accuracy of a stepwise two-photon excited melanin fluorescence in pigmented lesions suspicious for melanoma (FLIMMA study)

Introduction: Non-invasive, nanosecond, stepwise two-photon laser excitation of skin tissue was shown to induce melanin fluorescence spectra that allow for the differentiation of melanocytic nevi from cutaneous melanoma. Methods and analysis: This prospective, non-controlled, multicentre clinical study is performed to evaluate the diagnostic performance of the stepwise two-photon excited melanin fluorescence in the detection of cutaneous melanoma. The comparator will be the histopathological diagnosis. A total of 620 pigmented skin lesions suspicious for melanoma and intended for excision will be enrolled. Ethics and dissemination: Ethics approval was provided by the local ethics committees of the medical faculties of the University of Tuebingen, Heidelberg and Berlin. Study registration: The FLIMMA study NCT02425475

Phase 1 study of selinexor plus carfilzomib and dexamethasone for the treatment of relapsed/refractory multiple myeloma

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/150566/1/bjh15969.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/150566/2/bjh15969_am.pd

Współczesne kierunki w medycynie prewencyjnej

Praca recenzowana / Peer-reviewed paperTreści artykułów w niniejszej monografii odnoszą czytelnika nie tylko do bardzo różnych kierunków prozdrowotnych, ale także do leczenia schorzeń już występujących. Zamierzeniem autorów było przedstawienie wybranych zagadnień z zakresu profilaktyki prozdrowotnej cukrzycy, otyłości, zaburzeń lipidowych i zmian skórnych, pielęgnacji w tych schorzeniach, a także problemów kosmetologicznych skóry, towarzyszącym tymże zaburzeniom. Autorzy poszczególnych rozdziałów starali się przedstawić poruszane problemy w oparciu o aktualną dokumentację medyczną z nadzieją, że pozwoliło to kompleksowo wyjaśnić poruszane w monografii problemy

Two-step photon excitation of melanin fluorescence as a diagnostic-tool for melanoma

Einführung: Das Melanom ist ein maligner Tumor der Haut, der aus neoplas-tisch veränderten Melanozyten hervorgeht. Vor zwei Jahrzehnten galt dieser Tumor als selten, heute dagegen belegt er den fünften Platz der häufigsten Krebsneuerkrankungen in Deutschland. Das Melanom lässt sich durch die visu-elle klinische Früherkennung mithilfe der ABCD-Regel unter Verwendung eines Dermatoskops identifizieren. Ein Drittel der Melanome kann trotzdem klinisch nicht diagnostiziert werden. Mittlerweile gibt es eine Reihe von computergestütz-ten Screening-Geräten, die den Dermatologen bei der Beurteilung der Dignität einer Läsion unterstützen sollen. Ein innovatives Verfahren ist die stufenweise Zwei-Photonen-Melaninfluoreszenz oder auch Dermatofluoroskopie genannt. Methoden: In dieser klinischen Arbeit wurde die stufenweise Zwei-Photonen-Melaninfluoreszenz zur Diagnostik von 131 melanomsuspekten Läsionen an 119 Patienten angewendet. Hierbei wird das Melanin in der Hautveränderung mit einem Laser belichtet und die abgesendete Fluoreszenz ausgewertet. Die Fluo-reszenz des Melanins in einem Nävus unterscheidet sich von der des Mela-noms. Ein Melanom beinhaltet mehr Eumelanin und fluoresziert im roten Spekt-rum bei 620nm. Ein Nävus enthält mehr Pheomelanin-Moleküle und fluoresziert im grünen Spektrum. Basierend auf der Analyse dieser unterschiedlichen Fluo-reszenzspektren, wird von dem Dermatofluoroskop DFC-1 ein Score berechnet, der die untersuchte Läsion als benigne oder maligne einstuft. Die Sensitivität und Spezifität des Verfahrens wurde im Vergleich zur histopathologischen Diag-nose bestimmt. In der Zeit von Januar bis Juni 2016 wurden Patienten in der Klinik für Dermato-logie der Charité mit dem DFC-1 untersucht. Die Läsionen wurden anschlie-ßend exzidiert und histopathologisch verblindet evaluiert. Ergebnisse: In 92 von 131 Fällen zeigte das DFC-1 eine Übereinstimmung mit der histologischen Diagnose. Die Sensitivität der stufenweisen Zwei-Photonen-Melaninfluoreszenz beträgt in dieser In-vivo-Studie 48,4%, die Spezifität 77,0%. Die Messgenauigkeit des DFC-1 wurde auch unter Betrachtung von Subgruppen wie Geschlecht, Alter bei Diagnosestellung, Haarfarbe, Augenfarbe, Hauttyp, Bräunung, Sommersprossen während der Kindheit, Melanom in der Vorge-schichte und Anzahl vorhandener NZN analysiert. Hierbei zeigte sich das Ge-schlecht als statistisch signifikanter Einflussfaktor (p = 0,037). Es zeichnete sich eine Tendenz für eine höhere Sensitivität für Tumordicken über 2 mm ab. Der positive und negative prädiktive Wert betrug 39,5% und 82,8%. Schlussfolgerung: Die stufenweise Zwei-Photonen-Melaninfluoreszenz ist ein innovatives Verfahren zur Diagnostik von pigmentierten Hautveränderungen. Im untersuchten Patientenkollektiv zeigte sich, dass die Zwei-Photonen-Melaninfluoreszenz im klinischen Alltag zur Differenzierung von pigmentierten Hautveränderungen angewendet werden kann. Um die Zuverlässigkeit dieser diagnostischen Methode im klinischen Alltag zu prüfen, bedarf es weiterer klini-scher Studien und vor allem einer Anpassung des Messalgorithmus.Background: Melanoma is a malignant tumor of the skin, which emerges from neo-plastic transformed melanocytes. Two decades ago melanoma belonged to rare tumors, nowadays it is on the fifth place among the most frequent malig-nancies in Germany. According to the ABCD-rule melanoma can be identified by the examination with the unaided eye and dermoscopy assessment. One-third of all melanomas are still misdiagnosed. A number of computer-based screen-ing devices have been developed to support physicians in detecting melanomas at early stage. One of the technologies is the two-step photon excitation of mel-anin fluorescence also known as dermatofluoroscopy. Methods: The two-step photon excitation of melanin fluorescence was used to diagnose a total number of 131 melanocytic lesions with suspicion of melanoma. The melanin in the lesions is scanned by a two-step photon laser to evaluate the emitted fluorescence. The fluorescence spectrum of melanin within a naevus is different to the fluorescence spectrum of melanin in a melanoma. A melanoma contains more eumelanin, which sends a fluorescence of red spectrum at 620nm. A naevus contains more pheomelanin which sends a fluorescence of green spectrum. Based on the analysis of the different fluorescence spectra the DFC-1 device calculates a score which classifies the diagnosed lesions in malign or benign. The aim of this clinical study was to analyse the sensitivity and specificity of the method to compare it with the histopathological diagnosis. From January to June 2016 potential study participants (119 patients) were re-cruited and screened before excision and histopathological diagnosis of the le-sions at the Department of Dermatology of the Charité Berlin. Results: In 92 of 131 cases the DFC-1 device showed diagnostic agreement. The observed sensitivity in this in-vivo study was 48,4% and the specificity 77%. Furthermore the measuring accuracy was analysed regarding subgroups as gender, age at diagnosis, hair color, eye color, skin type, skin tanning, freckling during childhood, patient´s melanoma history and number of melanocytic naevi. The diagnostic accuracy of the two-step photon excitation was significantly high-er for male patients (p = 0,037) but other factors have no statistically signifi-cance. There was a trend for a higher sensitivity in thicker melanomas (>2mm) compared to thinner melanomas. The positive and negative predictive values of the DFC-1 were 39,5% and 82,8%. Conclusions: The two-step photon excitation of melanin fluorescence is an in-novative method to diagnose pigmented lesions. To prove the reliability of the diagnostic method further studies are needed as well as an adjustment of the measurement algorithm

Smart Cities in practice. A comparative case study between Warsaw, Gdynia, Copenhagen and Malmö. A public actor’s perspective with a secondary focus on collaboration and digitization

The purpose of this dissertation was to examine what Smart City concept entails in practice rather than a theory, with a clear secondary focus on digitization and collaboration as the means to deliver successful Smart City projects. This project sheds light on the public actor’s managerial perspective on many actual topics for the globalized world, where cities play a pivotal role. By interviewing deputy-mayors of the cities, strategists and project leaders, the author gives the opportunity to look at Smart City concept from a practical, rather than theoretical standpoint. The author also researched the importance of context for multiplying Smart City projects in different settings. The public actor’s perspective was based on the collected empirically-driven material from four different cities, located in three European countries: Warsaw, Gdynia, Copenhagen, and Malmö. The case study analysis with extensive empirical data, led the author to undermine the fully techno-centric vision of Smart Cities, that is most apparent in the theoretical discourse, in order to focus on a more holistic approach, where the different Smart City aspects are complementary to each other and most importantly, the citizens and their needs are treated as a priority. Hence, bringing the best possible service for inhabitants and being engaged in their growing expectations constitute a Smart City. To bring this best possible service and improve efficiency, cities should be proactive about the current pace of technological change, collaborate with different non-governmental parties and apply ICT and novel solutions. In line with the secondary objectives of this thesis, it was established that cross-sector collaboration and digitization are the means to deliver successful Smart City projects. Thanks to cross-sector collaboration and digitization, Smart City solutions result as more sustainable and better adjusted to citizens’ needs. The partnerships cities create become most beneficial, when they involve not only municipalities and private companies but also NGOs, research institutions as well as different civic organizations. This appears to be the modernized approach of managing change and uncertainty while handling innovation-based projects, in comparison to traditional principal-agent based governing schemes. The innovation-based projects, like Smart City projects, also require collaborations that are deeply based on trust, establishing mutual goals and openness between the municipalities and different sectors. Simultaneously, digital technologies and ICT reshape the way cities work, the way they cooperate with different stakeholders and communicate both internally and externally. Thus, cross-sector collaboration and digitization are the key factors to deliver successful Smart City projects. This dissertation can raise awareness and serve as an inspiration for private companies, municipalities and nongovernmental organizations on what can be examples of how to handle innovation-based projects, how the researched cities perceive collaboration with external parties and operate for their citizens