18 research outputs found

    Using cluster analysis with principal component analysis to study the iron metabolism in polycythemia vera

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    Background. Iron deficiency is a common complication in patients with polycythemia vera (PV). Unfortunately, little is known about the pathomechanisms of iron deficiency in PV. There have been no studies in the last decade documenting iron disorders in PV, despite progress in understanding the iron metabolism and new laboratory techniques measuring iron parameters.Objectives. The aim of this study was to assess the relationships between iron metabolism parameters, haematological and biochemical factors and clinical attributes in polycythemia vera patients with the use of cluster analysis (CA) and principal component analysis (PCA).Patients and methods. The study was performed on 60 patients (F/M 26/34) aged 38–84 (66 ± 10) years. The following parameters were determined in blood samples: hepcidin, prohepcidin, iron, total iron binding capacity (TIBC), unsaturated iron binding capacity (UIBC), ferritin, soluble transferrin receptor (sTfR), transferrin saturation (TfS), complete blood cell count, erythropoietin (Epo), uric acid, lactate dehydrogenase (LDH).Results. The CA divided all the 17 parameters into three clusters and showed that hepcidin concentrationis related to the duration of hydroxyurea therapy. PCA also revealed a positive correlation between hepcidin and therapy duration.Conclusions. We demonstrated that CA and PCA are efficacious methods for assessing the relationship between iron metabolism parameters and clinical attributes in PV patients

    Mathematical techniques for the protection of patient's privacy in medical databases

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    In modern society, keeping the balance between privacy and public access to information is becoming a widespread problem more and more often. Valid data is crucial for many kinds of research, but the public good should not be achieved at the expense of individuals. While creating a central database of patients, the CSIOZ wishes to provide statistical information for selected institutions. However, there are some plans to extend the access by providing the statistics to researchers or even to citizens. This might pose a significant risk of disclosure of some private, sensitive information about individuals. This report proposes some methods to prevent data leaks. One category of suggestions is based on the idea of modifying statistics, so that they would maintain importance for statisticians and at the same time guarantee the protection of patient's privacy. Another group of proposed mechanisms, though sometimes difficult to implement, enables one to obtain precise statistics, while restricting such queries which might reveal sensitive information

    Satisfaction and discontent of Polish patients with biological therapy of rheumatic diseases : results of a multi-center questionnaire study

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    Objectives: Biologics are medications widely applied in the management of inflammatory rheumatic diseases. The drugs were found to be effective but their application is associated with some disadvantages. Medication with biologics is relatively expensive, and in Poland, it is carried out in specialized centers. The study was designed to evaluate various aspects of satisfaction and dissatisfaction of Polish patients treated with biologics. Material and methods: An anonymous questionnaire was distributed in 23 Polish rheumatological centers involved in the treatment; 1212 returned questionnaires were used for analysis. Responses were received from 606 patients with rheumatoid arthritis, 427 with ankylosing spondylitis, 117 psoriatic arthritis, and 62 adult patients with juvenile idiopathic arthritis (in whom administration of the drugs had been introduced before they were 18 years old). The investigated group constituted about one-fifth of all rheumatic patients on biologics in Poland. Results: A beneficial or very beneficial influence of the medication on the state of physical health was found mostly in patients with rheumatoid arthritis (51.3 and 30.5%) and ankylosing spondylitis (51.0 and 36.8%). Family life was improved by the treatment especially in patients with ankylosing spondylitis (40.7 and 35.6% beneficial and very beneficial, respectively), sleep quality and sexual life mostly in those with ankylosing spondylitis (beneficial/very beneficial influence 41.5/38.4, and 38.7/23.9, respectively). There was a rather small influence of biological treatment on the financial situation of the patients. In general, satisfaction with the treatment was evaluated as positive or very positive in 88% of all investigated patients. In a significant part of the patients, transportation to the medical center was considered as a disadvantage of the treatment. About one-third of the patients considered laboratory and imaging tests to be done before initiation of the medication as a difficulty, and for about 40% waiting time for qualification for the medication was a significant disadvantage. The route of drug administration was without importance for 4/5 of the patients. Conclusions: Summing up, the results were similar in the patients suffering from various diseases although those with psoriatic arthritis felt the highest satisfaction (possibly due to the positive aesthetic effect), and those with ankylosing spondylitis had significant improvement in sexual life (probably due to younger age). Relatively low satisfaction was found in patients with juvenile idiopathic arthritis. There was a small influence of medication on financial status of the patients. Application of biologics has few disadvantages and most of them are associated with the organization of health services (waiting time for the tests, transportation to the medical centers)

    La structure génétique à fine échelle de population en France

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    La structure génétique à fine échelle des populations humaines est intéressante pour deux raisons principales : 1) elle reflète des événements historiques et démographiques, 2) elle informe la recherche sur les études d’association de maladies. Cette thèse a pour objectif de procéder à une analyse approfondie de la structure génétique de la population de France métropolitaine dans un premier temps, en de façon plus détaillée de la population du nord-ouest de la France, et de mettre en lumière les événements historiques, démographiques et culturels qui l’ont façonnés, en tirant parti de trois jeux de données (SU.VI.MAX/3C et PREGO). Au niveau de la France, nous rapportons la corrélation entre les données génétiques et les lieux de naissance d’individus appartenant à deux cohortes françaises indépendantes (1 414 et 770 individus) et identifions six groupes, concordants entre les jeux de données. La deuxième étude tire parti de la cohorte PREGO, qui comprend 3 234 personnes ayant trois générations d’ascendance liée à des régions spécifiques du nord-ouest de la France. Je révèle une structure à fine échelle à un niveau sans précédent (154 sous-populations).historique de la France et des explications potentielles de la prévalence de différentes maladies dans cette région du nord-ouest. Dans l’ensemble, mes travaux de thèse indiquent des niveaux substantiels de stratification de la population dans une région géographiquement limitée, probablement en raison de différents antécédents démographiques dans la région.Fine-scale genetic structure in human populations is interesting for two main reasons: 1), it reflects historical and demographic events, 2) it informs research on disease association studies. This thesis aims to perform a thorough analysis of the genetic structure of the population from continental France, in particular Northwestern France, and shed light on the historical, demographic and cultural events that have shaped it, by taking advantage of three genome-wide datasets (SU.VI.MAX/3C and PREGO) At the country level we report the correlation between genetic data and birthplaces of individuals in two independent French cohorts (1,414 and 770 individuals in SU.VI.MAX and 3C, respectively) and identify six clusters, concordant between datasets, and may correspond to ancient political, cultural and geographical borders. The second study takes advantage of the PREGO cohort including 3,234 individuals with three generations of ancestry linked to specific regions of Northwestern France and reveals fine-scale structure at an unprecedented level (154 subpopulations). The resulting genetic clusters and the characterisation of their effective population size and ancestry proportions compared to other European groups provide important and novel insights into the historical peopling of France and potential explanations for different disease prevalence within this northwestern region. Overall, my thesis work indicate substantial levels of population stratification within a geographically limited region likely caused by different demographic histories across the region

    Role of apelin in the regulation of glucose metabolism and of the cardiovascular system

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    Apelina jest jedną z aktywnych biologicznie adipokin syntetyzowanych przez tkankę tłuszczową. Należy do grupy białek transbłonowych sprzężonych z białkiem G i wykazuje największą homologię z receptorem angiotensyny II. Badania ostatnich lat wykazały obecność apeliny w różnych narządach, takich jak: układ pokarmowy, układ krążenia, mózg, płuca, wątroba, śledziona, nerki, gruczoł sutkowy człowieka, tkanka tłuszczowa i łożysko. Apelina poprzez działanie na swoisty receptor jest zaangażowana w regulację funkcji układu sercowo-naczyniowego, gospodarki wodno-elektrolitowej (kontrola łaknienia i przyjmowania płynów), szlaku sygnałowego w centralnym układzie nerwowym, odpowiedzi immunologicznej, a także w proces embriogenezy i stymulację angiogenezy. Apelina wydaje się odgrywać istotną rolę w patofizjologii chorób metabolicznych. Wykazano, że poprawia wrażliwość komórek na insulinę i może opóźniać rozwój zaburzeń metabolicznych towarzyszących otyłości. Ponadto, jej silne działanie inotropowo dodatnie oraz hipotensyjne powoduje, że może ona znaleźć zastosowanie w leczeniu chorób sercowo-naczyniowych i nadciśnienia tętniczego.Apelin is one of biologicaly active adipokines synthesised by adipose tissue. It belongs to the group of transmembrane G protein-coupled proteins and has the highest homology to the angiotensin II receptor. Recent studies has shown the presence of apelin in many different organs, such as: digestive system, circulatory system, brain, lungs, liver, spleen, kidney, human mammary gland, adipose tissue, and placenta. Apelina by acting at specific receptor is involved in the regulation of the cardiovascular, gastrointestinal and immune functions, hypothalamus-hypophysis axis modulation, as well as fluid homeostasis (water intake control), embryonal development and angiogenesis. Apelina seems to play an important role in the pathophysiology of metabolic diseases. It has been shown that apelin improves insulin sensitivity and delays the development of obesity-related metabolic disorders. Furthermore, the strong positive inotropic and hypotensive effect of apelin may find application in the treatment of cardiovascular diseases and hypertensio

    Thromboembolic Adverse Drug Reactions in Janus Kinase (JAK) Inhibitors: Does the Inhibitor Specificity Play a Role?

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    Recent advances in immunology enabled the characterization of several signal transmitting pathways responsible for proper cytokine and chemokine signaling. Among them, Janus kinases (JAKs) are essential components of receptor activation systems. The discovery of JAK kinases enabled the synthesis of JAK kinase inhibitors (JAKi or Jakinibs), which have proven to be efficacious in the treatment of hematologic malignancies and several rheumatological disorders and continue to be investigated in many clinical indications. Blocking multiple cytokines belonging to several cytokine families with a single small molecule may, however, create a potential risk for the patients. Recently, a higher risk of thromboembolic complications, namely, deep vein thrombosis and pulmonary embolism, has been recognized as the main concern during treatment with Jakinibs. At present, it is not entirely clear whether this increased risk is related to direct cytokine blockade, the presence of concomitant diseases in treated patients or other unknown circumstances that work together to increase the risk of this side effect. In this review, we discuss data on the risk of thromboembolic side effects, with special emphasis on the mechanism that may be responsible for this increased risk. Many indirect data indicate that higher thromboembolic risk may be related to the specificity of JAK inhibitor action, such that preferentially blocking one signaling pathway upsets the balance between pro and anti-thrombotic activities

    Cytometric Characterization of Main Immunocompetent Cells in Patients with Systemic Sclerosis: Relationship with Disease Activity and Type of Immunosuppressive Treatment

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    Systemic sclerosis (SSc) is a connective tissue disease that is characterized by widespread skin and internal organ fibrosis vasculopathy and immune response abnormalities, including T, B, natural killer (NK), and natural killer T (NKT) cell involvement. The aim of the study was to investigate the immune cell profile in patients with systemic sclerosis in relation to the disease activity, severity, and antibody presence and their relation to the type of immunosuppressive treatment. Cytometric examination identified following cell lines: B cells (Breg, B memory, B mature) and plasmablasts, T cell, T double positive—Tdp, T double negative—Tdn, NK, and NKT cell and monocytes. The disease severity and activity were assessed based on the Medsger and the EULAR Scleroderma Trials and Research Group (EUSTAR) 2017 scales respectively. In the study, SSc patients were characterized by higher total lymphocyte count parallel to increased frequency of Ts and Th cells. In SSc patients, increment of Tdp and reduction of Tdn as well as NK and NKT cells were observed. Additionally in SSc patients the reduction of B memory was noted. Head to head comparison between cyclophosphamide (CYC) and mycophenolate mofetil (MMF) treatment showed a reduction of CD19+ cells, but increment of plasmablasts in CYC treated patients
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