Evaluating the relationship of GDF-15 with clinical characteristics, cardinal features, and survival in multiple myeloma

Growth differentiation factor 15 (GDF-15), a member of the transforming growth factor-β superfamily, participates in processes associated with myeloma development and its end-organ complications. It plays a significant role in both physiological and abnormal erythropoiesis and regulates iron homeostasis through modulation of hepcidin. It is abnormally secreted in marrow stromal cells of patients with multiple myeloma (MM), which may reflect the tumor microenvironment. We analyzed the associations of serum GDF-15 with clinical characteristics of 73 MM patients (including asymptomatic MM) and the laboratory indices of renal function, anemia, and inflammation. Baseline serum GDF-15 was studied as the predictor of two-year survival. We defined five clinically relevant subgroups of patients (symptomatic MM only, patients with and without remission, patients on chemotherapy, and without treatment). Increased GDF-15 concentrations were associated with more advanced MM stage, anemia, renal impairment (lower glomerular filtration and higher markers of tubular injury), and inflammation. Most of the results were confirmed in the subgroup analysis. Serum cystatin C and urine neutrophil gelatinase-associated lipocalin were associated with GDF-15 independently of other variables. In the studied MM patients, GDF-15 did not significantly predict survival (p=0.06). Our results suggest that serum GDF-15 reflects myeloma burden and shares a relationship with several markers of prognostic significance, as well as major manifestations

The problem of increased vitamin D₃ level in a group of patients hospitalized in a geriatrics clinic

Wstęp Biorąc pod uwagę wielokierunkowe korzystne działanie witaminy D3 i jej rozpowszechniony niedobór także w populacji polskiej, powszechnie zaleca się jej regularną suplementację. Coraz więcej uwagi zwraca się jednak na ryzyko przedawkowania suplementowanej witaminy D3 i związane z tym poważne skutki zdrowotne. Materiał i metody Kontrola stężenia 25-hydroksywitaminy D (25(OH)D) jest rutynowym badaniem zalecanym przy przyjęciu do Kliniki Geriatrii Uniwersytetu Medycznego we Wrocławiu. Celem pracy była analiza uzyskanych wyników w okresie od stycznia 2018 r. do czerwca 2023 r. Dodatkowo zebrano informacje odnośnie do zgłaszanych objawów, płci i wieku osób ze stwierdzonym podwyższonym stężeniem witaminy D3. Wyniki Analizując grupę 1400 pacjentów, odnotowano, że w ciągu 5 lat wartości przekraczające zalecane stężenia witaminy D3 odnotowano u 7 pacjentów, w tym u 3 był to poziom toksyczny. Wszystkie nieprawidłowe wyniki dotyczyły kobiet. W analizowanej populacji wśród najczęściej zgłaszanych objawów dominowały skargi na ogólne osłabienie, bóle kończyn dolnych, bóle stawów, zaburzenia snu i obniżenie nastroju. Dodatkowo osoby ze stężeniem toksycznym zgłaszały zawroty głowy. Analiza wykazała, że w populacji geriatrycznej obserwuje się stopniowy wzrost stężenia witaminy D i rzadziej występuje jej niedobór. Wyższe i toksyczne stężenia odnotowano u pacjentów >74 r.ż. Suplementy i leki z witaminą D są najczęściej stosowane bez konsultacji z lekarzem, bez ustalenia właściwej dawki i bez oceny stężenia 25(OH)D w surowicy. Wnioski W prewencji niedoboru witaminy D u osób >65 r.ż. nie należy stosować dawek >4000 j.m./d. Wskazana jest ocena wszystkich przyjmowanych przez seniorów leków i suplementów diety przy każdej wizycie lekarskiej pod względem powielania leczenia także witaminą D. W populacji osób starszych wskazana jest ocena stanu zaopatrzenia w witaminę D poprzez oznaczenia stężenia 25(OH)D w celu doboru właściwej dawki i korekty suplementowania. Oznaczenie stężenia 1,25-dihydroksywitaminy D jest wskazane w przypadku zatrucia witaminą D w celu wykluczenia jej pozanerkowej hydroksylacji.Background Taking into account the multi-directional beneficial effects of vitamin D3 and its widespread deficiency, regular supplementation is recommended. However, more and more attention is being paid to the risk of overdose with supplemented vitamin D3 and the associated serious health consequences. Material and Methods The concentration of 25-hydroxyvitamin D (25(OH)D) is a routine test recommended upon admission to the Geriatrics Clinic of Wroclaw Medical University. The aim of the study was to analyze the results from January 2018 to June 2023. Additionally, information on the reported symptoms, gender and age of people with an increased level of vitamin D3 was collected. Results Analyzing a group of 1400 patients, it was noted that within 5 years, vitamin D3 concentrations exceeding the recommended level were recorded in 7 patients, including 3 with toxic levels. All abnormal results occurred in women. The most frequently reported symptoms included general weakness, lower limbs and joint pain, sleep disorders, low mood. People with toxic concentrations reported dizziness. In seniors there is a gradual increase in vitamin D concentration and its deficiency is less common. Higher concentrations were recorded in the group of older seniors, and concentrations considered toxic occur in the population >74 years of age. Supplements and drugs with vitamin D are most often used without consulting a doctor, without determining the appropriate dose, or without assessing the concentration of 25(OH)D in the serum. Conclusions To prevent vitamin D deficiency in seniors, doses >4000 IU daily are not recommended. It is advisable to check all medications and supplements taken at each doctor’s visit in terms of duplicating treatment with vitamin D. It is advisable to assess the status of vitamin D supply the concentration of 25(OH)D in order to select the appropriate dose. Assessment of 1,25-dihydroxyvitamin D concentration is recommended in cases of vitamin D toxicity

Bioethical Aspects of Unconventional Medicine in the Family Medicine Practice

Unconventional or alternative medicine became one of the most popular subject in modern life. That kind of natural medicine gives the new chances for the big group of deeply sick patients. They want to find a new hope for their future. Family doctor is obligated to have the full information about the alternative methods of therapy. Some of that natural methods can be usefull for doctors practice (only methods with scientific base). But from the other side in Poland only doctors with university or medical academy diploma can make health diagnosis or medical treatment and after that kind of studies they can use the title of doctor or professor of medicine.Zadanie pt. „Digitalizacja i udostępnienie w Cyfrowym Repozytorium Uniwersytetu Łódzkiego kolekcji czasopism naukowych wydawanych przez Uniwersytet Łódzki” nr 885/P-DUN/2014 dofinansowane zostało ze środków MNiSW w ramach działalności upowszechniającej naukę

An Array SPRi Biosensor for the Determination on PARP-1 in Blood Plasma

A biosensor was developed for the quantification of poly(ADP-ribose) polymerase-1 (PARP-1) in body fluids. An antibody specific for PARP-1 was placed on a chip with cysteamine (linker) and a gold layer. This biosensor has a linear response range (10–1000 pg∙mL−1) under appropriate pH conditions and with an antibody ligand concentration of 5 ng∙mL−1. Plasma samples were diluted with PBS buffer in appropriate quantities so that they fell within the linear range of the calibration curve. The biosensor exhibited suitable precision and accuracy, and good recovery (at levels from 95% to 105%). The method was validated by means of PARP-1 determinations in plasma samples from patients with endometriosis and a control group, using surface plasmon resonance imaging (SPRi) biosensors and an enzyme-linked immunosorbent assay (ELISA) test. The Spearman correlation coefficient was close to 1. PARP-1 may be a marker providing information about pathological changes in the body during endometriosis

The Impact of Different Types of Diet on the Prevention of Diseases among Polish Inhabitants, Including COVID-19 Disease

Proper nutrition may help in preventing deaths or at least alleviating the symptoms of many chronic diseases. While the COVID-19 disease was still taking its toll, the world had to adjust to new life conditions, which could change nutritional habits. In this observational, cross-sectional study, we aimed to identify the potential correlations between sociodemographic factors and diet and the presence of common chronic diseases among Polish inhabitants. Furthermore, we tried to determine whether the COVID-19 pandemic led to changes in nutritional habits. Therefore, based on the online study (the National Test for Poles’ Health (NTPH), we collected data from 376,102 and 200,000 respondents in two different time frames (before the COVID-19 pandemic: 2019–2020 and during the COVID-19 pandemic: 2021–2022, respectively). Despite the rapid global rise of the COVID-19 pandemic, among our study group, hypertension was still the most commonly occurring disease in both time frames (32.33% in 2019–2020 and 34.95% in 2021–2022, p p p p p = 0.001; and OR = 0.73, CI 95% (0.55–0.96), p = 0.026). In line with this, consuming meat meals increases the risk of hypertension (OR = 1.09, CI 95% (1.02–1.17), p = 0.009). Interestingly, a reduced-sodium diet has an association with decreased morbidity of COVID-19 disease (OR = 0.72, CI 95% (0.63–0.82), p < 0.001). This result brings new light to more research to be done to allow efficient prevention of this disease. In conclusion, our study shows the beneficial role of a balanced diet in reducing the incidence rate of common chronic diseases. Our findings may be educational for those who would like to change their nutritional habits and/or for public health professionals to suggest the implementation of proper diets to their patients

The Usefulness of the COVID-GRAM Score in Predicting the Outcomes of Study Population with COVID-19

Background: The COVID-GRAM is a clinical risk rating score for predicting the prognosis of hospitalized COVID-19 infected patients. Aim: Our study aimed to evaluate the use of the COVID-GRAM score in patients with COVID-19 based on the data from the COronavirus in the LOwer Silesia (COLOS) registry. Material and methods: The study group (834 patients of Caucasian patients) was retrospectively divided into three arms according to the risk achieved on the COVID-GRAM score calculated at the time of hospital admission (between February 2020 and July 2021): low, medium, and high risk. The Omnibus chi-square test, Fisher test, and Welch ANOVA were used in the statistical analysis. Post-hoc analysis for continuous variables was performed using Tukey&rsquo;s correction with the Games&ndash;Howell test. Additionally, the ROC analysis was performed over time using inverse probability of censorship (IPCW) estimation. The GRAM-COVID score was estimated from the time-dependent area under the curve (AUC). Results: Most patients (65%) had a low risk of complications on the COVID-GRAM scale. There were 113 patients in the high-risk group (13%). In the medium- and high-risk groups, comorbidities occurred statistically significantly more often, e.g., hypertension, diabetes, atrial fibrillation and flutter, heart failure, valvular disease, chronic kidney disease, and obstructive pulmonary disease (COPD), compared to low-risk tier subjects. These individuals were also patients with a higher incidence of neurological and cardiac complications in the past. Low saturation of oxygen values on admission, changes in C-reactive protein, leukocytosis, hyperglycemia, and procalcitonin level were associated with an increased risk of death during hospitalization. The troponin level was an independent mortality factor. A change from low to medium category reduced the overall survival probability by more than 8 times and from low to high by 25 times. The factor with the strongest impact on survival was the absence of other diseases. The medium-risk patient group was more likely to require dialysis during hospitalization. The need for antibiotics was more significant in the high-risk group on the GRAM score. Conclusion: The COVID-GRAM score corresponds well with total mortality. The factor with the strongest impact on survival was the absence of other diseases. The worst prognosis was for patients who were unconscious during admission. Patients with higher COVID-GRAM score were significantly less likely to return to full health during follow-up. There is a continuing need to develop reliable, easy-to-adopt tools for stratifying the course of SARS-CoV-2 infection

Plasma and Peritoneal Fluid ZEB Levels in Patients with Endometriosis and Infertility

Zinc finger E-box-binding homeobox 1 (ZEB1) and zinc finger E-box-binding homeobox 2 (ZEB2) are transcription factors that regulate epithelial&ndash;mesenchymal transformation (EMT). The aim of this study was to compare levels of ZEB1 and ZEB2 in the peritoneal fluid and plasma between patients with and without endometriosis in order to assess their utility in the diagnostic process. Plasma and peritoneal fluid samples were collected from 50 patients with and 48 without endometriosis during planned surgical procedures in eight clinical centers. Quantitative ZEB1 and ZEB2 levels analyses were performed using a double-antibody sandwich enzyme-linked immunosorbent assay (ELISA). No significant differences were observed in ZEB1 levels in any of the subanalyses nor any differences regarding ZEB2 levels between patients with and without endometriosis. Plasma ZEB2 levels were significantly higher among patients with infertility compared to fertile women (16.07 &plusmn; 12.70 ng/L vs. 12.07 &plusmn; 11.92 ng/L; p &lt; 0.04). Both ZEB1 and ZEB2 do not seem to have a significant value in the initial diagnosis of endometriosis as a single marker. The differences in ZEB2 plasma levels between patients with and without infertility indicate the possibility of EMT dysregulation in the pathogenesis of adverse fertility outcomes

Plasma and Peritoneal Poly (ADP-Ribose) Polymerase Levels in Patients with Endometriosis

The evidence of poly (ADP-ribose) polymerase (PARP) association with the immune response could be coherent with the immunological theory of endometriosis and suggests the possibility of a new research direction. The aim of the study was to evaluate the levels of PARP in plasma and peritoneal fluid of patients with and without endometriosis. It was a multicenter, cross-sectional study. Plasma and peritoneal fluid samples were collected from patients with and without endometriosis during planned laparoscopic procedures in eight clinical centers. In total, 84 samples of plasma and 84 samples of the peritoneal fluid were included in the final analyses. Double-antibody sandwich enzyme-linked immunosorbent assay was performed in order to assess levels of PARP in collected samples. No statistically significant differences regarding the detected levels of PARP in plasma and peritoneal fluid comparing patients with and without endometriosis were observed. Patients with a history of infertility had significantly higher plasma PARP concentrations (p = 0.04). We have not observed the potential role of PARP concentration levels in plasma nor peritoneal fluid as an endometriosis biomarker. We have determined an association between a higher plasma PARP concentration and a history of infertility