Is urinary type IV collagen a good marker of early impairment of renal function in childhood cancers survivors?

Introduction: Nephrotoxicity, as a side effect of antineoplastic treatment, can occur in childhood cancer survivors (CCSs). It worsens their quality of life especially if it leads to chronic kidney disease (CKD). Collagen turnover is known to be disturbed in CKD. Urinary type IV collagen (U-Col4) is recognized as an exponent of extracellular matrix synthesis and degradation in glomeruli and is thus involved in this turnover. The purpose of this study was to evaluate the usefulness of U-Col4 in assessing early renal impairment in CCSs. Material and methods: Seventy-eight CCSs, without CKD, bilateral kidney tumors, congenital kidney defects, urinary tract infections and diabetes, at least one year after ending antineoplastic treatment, and aged 1–18 years, were divided into three groups: 1) patients after nephroblastoma treatment (n = 18); 2) patients after other solid tumors treatment (n = 42); and 3) patients after anti-hamatopoietic and lymphatic system proliferative treatment (n = 18). Concentrations of creatinine and cystatin C in serum, and of albumin, creatinine, N-acetyl-β-D-glucosaminidase (NAG), and U-Col4 in urine, were measured, and a general urine analysis was performed. The albumin-creatinine ratio (ACR), the urine U-Col4/creatinine ratio, the urine NAG/creatinine ratio and the estimated glomerular filtration rate were calculated according to the Schwartz equation and the Filler equation. Results: We did not find any differences between the groups in the evaluated biochemical parameters. Weak negative correlations were found between U-Col4 and urine NAG/creatinine ratio (p = 0.02, R = –0.27) and ACR (p = 0.00, R = –0.39). Conclusions: Evaluation of the usefulness of U-Col4 in assessing early renal impairment in CCSs requires further study. CCSs should be monitored for potential complications of antineoplastic treatment, even many years after its completion

Synthesis and Mass Spectrometry Analysis of Mimosine-Containing Peptides

AbstractNon-proteinogenic amino acids are widely explored group of compounds due to their chemical properties and great potential of application in the combinatorial chemistry, medicinal investigation etc. Therefore the synthetic methods of their incorporation to the peptide chain are required. l-Mimosine, (S)-α-amino-β-(3-hydoxy-4-oxo-1,4-dihydropyridin-1-yl)-propanoic acid), is a plant amino acid, known to induce apoptosis in human pancreatic cancer xenografts. Here we present our investigations on the synthesis of mimosine-containing peptide and their ESI-MS/MS analysis. We successfully applied Fmoc-protected mimosine a with a free hydroxy ketone group for efficient peptide synthesis in the presence of HATU as a coupling reagent without the formation of side products. Additionally the tandem mass spectrometry analysis revealed the characteristic loss of the heterocyclic ring from mimosine residue side chain. The described method allows insertion of mimosine residue at any endo-position within a peptide sequence. The obtained results may be useful in the synthesis and mass spectrometry analysis of various mimosine-containing peptides

Odległe następstwa leczenia nowotworów złośliwych u dzieci

W ostatnich latach dzięki intensywnej skojarzonej terapii przeciwnowotworowej zwiększa się liczba dzieci wyleczonych z choroby nowotworowej. W związku z powyższym wzrasta liczebność populacji, u której obserwuje się późne następstwa samej choroby nowotworowej oraz jej terapii

Contemporary treatment options for male hypogonadism

Introduction Male hypogonadism is a disease in which testicular function is impaired. Its symptoms are due to testosterone deficiency and most of them show low specificity. These include reduced libido, erectile dysfunction and mood disorders, among others. The biochemical indicator of hypogonadism is a testosterone concentration below 350 ng/ml (12nmol/L), according to the European Association of Urology (EAU). The increased incidence of hypogonadism is associated with aging and the presence of comorbidities such as type II diabetes and obesity. Men with testosterone deficiency have an increased risk of cardiovascular disease and premature death. Goals Summary of current reports on the diagnosis and treatment of hypogonadism. An overview of the advantages and disadvantages of the different types of formulations used in testosterone replacement therapy. MethodsReview of literature available in PubMed and Google Scholar databases. Conclusions The medical interview, physical examination and ancillary tests help to classify hypogonadism appropriately. Measuring the concentration of gonadotropins, helps diversify primary from secondary hypogonadism. Testosterone replacement therapy (TRT) uses formulations that have varying release profiles, route of administration and drug formulation. The choice of testosterone product should involve age, lifestyle, and individual preferences of the patient

Wound packing trainee construction

Haemorrhage is one of the main causes of death in injuries in both civilian and military conditions. Controlling bleeding is the most important task facing the rescuer when helping a casualty. There are many ways to control bleeding, but these methods are often misused. Most of the methods described have their roots in battlefield medicine developed on the basis of experience from armed conflicts. Currently, there is a clear trend towards adapting tactical medicine solutions for civil rescues because they are effective and simple. Increased awareness among civilian rescuers and regular training will hopefully lead to more effective help for injured people. The authors' work focused on the construction of an effective trainer to mimic a hip wound and a practical examination of how training affects the time to stop bleeding using the wound packing technique

Co wiemy o nefrotoksyczności metotreksatu u dzieci?

Metotreksat (MTX) to jeden z najszerzej stosowanych leków przeciwnowotworowych. Obok cisplatyny i ifosfamidu jest jednym z 3 cytostatyków, których nefrotoksyczność jest szeroko omawiana w piśmiennictwie. Duże dawki MTX mogą być bezpiecznie podawane pacjentom z prawidłową funkcją nerek pod warunkiem nawadniania, alkalizacji i farmakokinetycznie prowadzonej terapii „ratunkowej” leukoworyną. W pracy przedstawiono właściwości chemiczne i mechanizm działania MTX. Omówiono patofizjologię, czynniki ryzyka, charakterystykę kliniczną nefrotoksyczności MTX oraz postępowanie profilaktyczne i terapeutyczne. Forum Nefrologiczne 2011, tom 4, nr 1, 20–2

Sonographic Image of Solitary Kidney in Wilms Tumour Survivors

Background/Aims: This study presents an analysis of the sonographic and laboratory parameters of solitary kidney in Wilms tumour survivors (TWs) and compares these parameters with those of healthy individuals. Methods: Fifty-three TWs who completed treatment for Wilms tumour and 44 healthy individuals were enrolled. The study protocol consisted of completing a medical history, sonographic examination of the solitary kidney, estimation of glomerular filtration rate (eGFR) by the Schwartz or MDRD formulas, albumin urine excretion and BP measurement. Results: Sonographic signs of kidney damage were observed in 22 (41,5%) TWs. The most frequently detected abnormalities are hyperechoic rings around renal pyramids (28,3% TWs). Hypertrophy of the solitary kidney occurred in 71,7% of cases. The mean volume of the solitary kidney was 77% of the sum of the two kidney volumes in the control group. The median eGFR in the TWs group was 117 with 25Q-105,5, 75Q-130 ml/min/1,73 m2 vs 131,8 with 25Q-124, 75Q-140 ml/min/1,73 m2 in the control group (p=0,000). Six TWs (11,3%) had a value of eGFR below 90 ml/min/1,73 m2. Increased urine albumin excretion (> 30 mg/g) was observed in 7 TWs (13,2%) and in 3 (6,8%) individuals in the control group. Conclusion: Ultrasonographic abnormalities in solitary kidney of TWs are frequent. The most frequently detected abnormalities are hyperechoic rings around renal pyramids. Sonographic examination of TWs ought to be performed not only to detect tumour recurrence but also to assess the signs of kidney damage and their progression

Ostatecznie gruźlica, a nie choroba nowotworowa. Prezentacja trzech przypadków pediatrycznych

Gruźlica wieku dziecięcego należy obecnie w krajach wysoko rozwiniętych do rzadkości. W pracy zaprezentowano przypadki trojga dzieci z objawami nasuwającymi podejrzenie choroby nowotworowej, u których ostatecznie dzięki interwencji chirurgicznej rozpoznano gruźlicę (węzłowo-płucną, wielonarządową oraz ściany klatki piersiowej). Tylko u jednej pacjentki uzyskano potwierdzenie bakteriologiczne. Objawy gruźlicy wymagają różnicowania z chorobą nowotworową. Chirurg, który pobiera materiał diagnostyczny, powinien pamiętać o wykonaniu badań bakteriologicznych w kierunku gruźlicy. Forum Medycyny Rodzinnej 2010, tom 4, nr 6, 464–47

Improvement of cure after hematopoietic stem cel transplantations in children

Background. Hematopoietic stem cell transplantation (HSCT) is an established procedure for many acquired and congenital disorders of the hematopoietic system, including malignancies, bone marrow failure syndromes, disorders of the immune system, and metabolic disorders. Objective. Analysis of results of hematopoietic stem cell transplantations performed over a period of 12 years in a single pediatric center. Patients and methods. All transplants performed between 2003 and 2015 in the Department of Pediatric Hematology and Oncology in Bydgoszcz were included in this analysis. The results of therapy with stem cell transplantation were analyzed in three time periods: 2004-2007, 2008-2011 and 2012-2015. Results. A total number of transplants was 318, including 132 auto-HSCT and 186 allo-HSCT. Among allogeneic transplants, 68 were done from matched-sibling donor and 118 from alternative donor. The mean survival for all patients estimated by Kaplan-Meier method was 8.1 years. Probability of overall survival (pOS) after all transplants was 0.64±0.03. pOS after allo-HSCT was 0.62±0.04, and 0.67±0.05 after auto-HSCT. Overall survival for patients transplanted in the second (2008-2011) and third (2012-2015) time period was comparable both for auto- and allo-HSCT. However, it was significantly higher than for patients transplanted in the first period of time (2004-2007) for all patients, and for those undergoing auto-HSCT. In allo-HSCT patients, in spite of increase of over 20% in pOS (43% vs 66% vs 64% in respective time periods), the difference was not statistically significant. Conclusion. Presented results of HSCT obtained in our center are comparable with those from other international registries and centers.Wstęp. Transplantacja komórek krwiotwórczych (HSCT) jest ważną metodą terapeutyczną w wielu wrodzonych i nabytych chorobach, w tym nowotworowych, zespołach niewydolności szpiku oraz zaburzeniach immunologicznych i metabolicznych. Celem pracy jest analiza wyników HSCT w pojedynczym ośrodku pediatrycznym w okresie 12 lat. Pacjenci i metodyka. Analizie poddano wyniki przeszczepień wykonanych w latach 2003-2015 w Klinice Pediatrii, Hematologii i Onkologii w Bydgoszczy. Transplantacje analizowano w trzech przedziałach czasowych: 2004-2007, 2008-2011 oraz 2012-2015. Wyniki. Wykonano 318 HSCT, w tym 186 alloge-nicznych (68 zgodnych rodzinnych i 118 od dawców alternatywnych) oraz 132 autologiczne. Średnie przeżycie po HSCT, wyznaczone metodą Kaplana-Meiera wyniosło 8,1 lat. Całkowite prawdopodobieństwo przeżycia (pOS) wyniosło 0,64±0,03; pOS po allo-HSCT wynosi 0,62±0,04, a po auto-HSCT 0,67±0,05. Nie wykazano znamiennych różnic w pOS zarówno po allo-HSCT, jak i po auto-HSCT pomiędzy drugim (2008-2011) i trzecim (2012-2015) analizowanym okresie. Jednakże, pOS było wyższe w dru-gim i trzecim okresie w stosunku do okresu pierwszego (2004-2007), zarówno dla wszystkich pacjentów, jak i u pacjentów po auto-HSCT. W grupie pacjentów allo-HSCT, uzyskano wzrost pOS o ponad 20% (43% vs 66% vs 64% w kolejnych przedziałach czasu; ns). Wnioski. Wyniki HSCT uzyskiwane aktualnie w na-szym ośrodku są porównywalne z wynikami podawanymi w międzynarodowych rejestrach

Wzrost wyleczalności po transplantacji komórek hematopoetycznych u dzieci

Background. Hematopoietic stem cell transplantation (HSCT) is an established procedure for many acquired and congenital disorders of the hematopoietic system, including malignancies, bone marrow failure syndromes, disorders of the immune system, and metabolic disorders.Objective. Analysis of results of hematopoietic stem cell transplantations performed over a period of 12 years in a single pediatric center.Patients and methods. All transplants performed between 2003 and 2015 in the Department of Pediatric Hematology and Oncology in Bydgoszcz were included in this analysis. The results of therapy with stem cell transplantation were analyzed in three time periods: 2004-2007, 2008-2011 and 2012-2015.Results. A total number of transplants was 318, including 132 auto-HSCT and 186 allo-HSCT. Among allogeneic transplants, 68 were done from matched-sibling donor and 118 from alternative donor. The mean survival for all patients estimated by Kaplan-Meier method was 8.1 years. Probability of overall survival (pOS) after all transplants was 0.64±0.03. pOS after allo-HSCT was 0.62±0.04, and 0.67±0.05 after auto-HSCT. Overall survival for patients transplanted in the second (2008-2011) and third (2012-2015) time period was comparable both for auto- and allo-HSCT. However, it was significantly higher than for patients transplanted in the first period of time (2004-2007) for all patients, and for those undergoing auto-HSCT. In allo-HSCT patients, in spite of increase of over 20% in pOS (43% vs 66% vs 64% in respective time periods), the difference was not statistically significant.Conclusion. Presented results of HSCT obtained in our center are comparable with those from other international registries and centers.Wstęp. Transplantacja komórek krwiotwórczych (HSCT) jest ważną metodą terapeutyczną w wielu wrodzonych i nabytych chorobach, w tym nowotworowych, zespołach niewydolności szpiku oraz zaburzeniach immunologicznych i metabolicznych.Celem pracy jest analiza wyników HSCT w pojedynczym ośrodku pediatrycznym w okresie 12 lat.Pacjenci i metodyka. Analizie poddano wyniki przeszczepień wykonanych w latach 2003-2015 w Klinice Pediatrii, Hematologii i Onkologii w Bydgoszczy. Transplantacje analizowano w trzech przedziałach czasowych: 2004-2007, 2008-2011 oraz 2012-2015.Wyniki. Wykonano 318 HSCT, w tym 186 alloge-nicznych (68 zgodnych rodzinnych i 118 od dawców alternatywnych) oraz 132 autologiczne. Średnie przeżycie po HSCT, wyznaczone metodą Kaplana-Meiera wyniosło 8,1 lat. Całkowite prawdopodobieństwo przeżycia (pOS) wyniosło 0,64±0,03; pOS po allo-HSCT wynosi 0,62±0,04, a po auto-HSCT 0,67±0,05. Nie wykazano znamiennych różnic w pOS zarówno po allo-HSCT, jak i po auto-HSCT pomiędzy drugim (2008-2011) i trzecim (2012-2015) analizowanym okresie. Jednakże, pOS było wyższe w dru-gim i trzecim okresie w stosunku do okresu pierwszego (2004-2007), zarówno dla wszystkich pacjentów, jak i u pacjentów po auto-HSCT. W grupie pacjentów allo-HSCT, uzyskano wzrost pOS o ponad 20% (43% vs 66% vs 64% w kolejnych przedziałach czasu; ns).Wnioski. Wyniki HSCT uzyskiwane aktualnie w na-szym ośrodku są porównywalne z wynikami podawanymi w międzynarodowych rejestrach