Iron Inhibits Respiratory Burst of Peritoneal Phagocytes In Vitro

Objective. This study examines the effects of iron ions Fe3+ on the respiratory burst of phagocytes isolated from peritoneal effluents of continuous ambulatory peritoneal dialysis (CAPD) patients, as an in vitro model of iron overload in end-stage renal disease (ESRD). Material and Methods. Respiratory burst of peritoneal phagocytes was measured by chemiluminescence method. Results. At the highest used concentration of iron ions Fe3+ (100 μM), free radicals production by peritoneal phagocytes was reduced by 90% compared to control. Conclusions. Iron overload may increase the risk of infectious complications in ESRD patients

Peritonitis-induced antitumor activity of peritoneal macrophages from uremic patients.

The macrophages belong to the effector cells of both nonspecific and specific immune response. These cells generally express little cytotoxicity unless activated. The present work was intended to determine if peritoneal macrophages collected from patients on Continuous Ambulatory Peritoneal Dialysis (CAPD) during episodes of peritonitis were active against human tumor cell lines without further in vitro stimulation. We also compared macrophage antitumor potential with effectiveness of drugs used in cancer therapy (taxol and suramin). Conditioned medium (CM) of macrophages collected during inflammation-free periods did not exhibit cytostatic and cytotoxic activity against both tumor (A549 and HTB44) and non-transformed (BEAS-2B and CRL2190) cells. Exposure of tumor cells to CM of macrophages harvested during peritonitis resulted in significant suppression of proliferation, impairment of viability and induction of apoptosis, in contrast to non-transformed cells, which remained unaffected. The efficacy of CM of inflammatory macrophages as an antitumor agent appeared to be comparable to cytostatic and cytotoxic potency of taxol and suramin or, in the case of HTB44 cells, even higher. The results obtained suggest that activated human macrophages might represent a useful tool for cancer immunotherapy

Peritonitis-induced antitumor activity of peritoneal macrophages from uremic patients

The macrophages belong to the effector cells of both nonspecific and specific immune response. These cells generally express little cytotoxicity unless activated. The present work was intended to determine if peritoneal macrophages collected from patients on Continuous Ambulatory Peritoneal Dialysis (CAPD) during episodes of peritonitis were active against human tumor cell lines without further in vitro stimulation. We also compared macrophage antitumor potential with effectiveness of drugs used in cancer therapy (taxol and suramin). Conditioned medium (CM) of macrophages collected during inflammation-free periods did not exhibit cytostatic and cytotoxic activity against both tumor (A549 and HTB44) and non-transformed (BEAS-2B and CRL2190) cells. Exposure of tumor cells to CM of macrophages harvested during peritonitis resulted in significant suppression of proliferation, impairment of viability and induction of apoptosis, in contrast to non-transformed cells, which remained unaffected. The efficacy of CM of inflammatory macrophages as an antitumor agent appeared to be comparable to cytostatic and cytotoxic potency of taxol and suramin or, in the case of HTB44 cells, even higher. The results obtained suggest that activated human macrophages might represent a useful tool for cancer immunotherapy

The Adherence in Chronic Diseases Scale — a new tool to monitor implementation of a treatment plan

Wstęp. Celem pracy była ocena adherence z zastosowaniem nowej skali w populacji osób z chorobą wieńcową (CAD) po zawale serca (MI) w odniesieniu do parametrów socjodemograficznych i klinicznych. Materiał i metody. Badanie przeprowadzono w populacji 100 kolejnych osób (40 kobiet, 60 mężczyzn) w wieku 30–88 lat, średnio 63,4 roku, pół roku po hospitalizacji z powodu MI. Wyniki. Wyniki oceny w Adherence in Chronic Diseases Scale (ACDS) zawierały się między 6 a 28 punktów; mediana wynosiła 24 punkty (21–28). Wynik wysoki (> 26 pkt.) osiągnęły 24 osoby, 53 badanych uzyskało wynik średni (między 21 a 26 pkt.), a 23 — niski wynik (< 21 pkt.). Dla optymalnego modelu regresji wielorakiej współczynnik korelacji R wynosił 0,539, a skorygowany współczynnik determinacji R2 — 0,26 (p = 0,000002). Niezależnymi czynnikami wpływającymi na adherence ocenianymi w ACDS były: subiektywna ocena stanu zdrowia (b = 0,48 ± 0,23; p = 0,036), wiek badanych (b = –0,11 ± 0,04; p = 0,004), więcej niż jeden pobyt w szpitalu z powodu CAD (b = –1,78 ± 0,87; p = 0,044) oraz cukrzyca (b = –2,02 ± 0,91; p = 0,029). Wnioski. Subiektywna ocena stanu zdrowia, wiek pacjentów, liczba hospitalizacji z powodu CAD oraz współwystępowanie cukrzycy wpływają na adherence w terapii przewlekłej po zawale serca.Introduction. The aim of this study was to assess adherence to treatment with use of the new scale in a population of patients with coronary artery disease (CAD) after myocardial infarction (MI) with respect to some socio-demographic and clinical factors. Material and methods. The study was conducted in a population of 100 consecutive patients (40 women, 60 men) aged from 30 to 88 years (mean 63.4), six months after hospitalization for MI. Results. The results of the assessment with the Adherence in Chronic Diseases Scale (ACDS) comprise between 6 and 28 points; median 24 points (21–28). Twenty-four patients had high score (> 26 pts.), 53 patients had intermediate score (between 21–26 pts.) and 23 — low score (< 21 pts.). For optimal model of multiple regression, the correlation coefficient R was 0.539; and the adjusted coefficient of determination R2 = 0.26, p = 0.000002. Independent factors affecting adherence according to the ACDS scale were: subjective assessment of health status (b = 0.48 ± ± 0.23, p = 0.036), age of the respondents (b = –0.11 ± 0.04, p = 0.004), more than one hospitalization due to CAD (b = –1.78 ± 0.87, p = 0.044), and diabetes mellitus (b = –2.02 ± 0.91, p = 0.029). Conclusions. Subjective assessment of health status, age of patients, the number of hospitalizations due to CAD and diabetes affect the adherence in the course of long-term treatment after myocardial infarction.

When Common Medications Trigger a Rare Reaction: A Review of Clinical Features, Diagnosis, and Treatment Options of DRESS Syndrome

Introduction and purpose: Drug-induced reaction with eosinophilia and systemic symptoms (DRESS) is a severe, life-threatening systemic drug reaction. The challenges in identifying DRESS syndrome result from its symptoms being variable, diverse, and unspecific. Due to the potentially lethal consequence, any clinician should be aware of the symptomatology and be prepared to initiate the appropriate steps. This review summarizes the clinical manifestations and provides essential information on the management of the illness.     State of knowledge: DRESS appears to be a rare reaction that frequently remains undetected due to its atypical clinical presentation. Fever, skin rash, lymphadenopathy, eosinophilia, and organ involvement as well as other manifestations, may occur. The onset may be delayed by weeks after exposure to the offending drug. DRESS syndrome is classified as a type IV hypersensitivity. It is thought to be triggered by antiepileptic drugs and antibiotics although many other medications can cause the condition. Certain genetic factors may also predispose some individuals to develop DRESS. Combining clinical and laboratory findings can help confirm the diagnosis. Discontinuation of the offending drug is the fundamental component of treatment such as supportive care including the use of antihistamines and corticosteroids, but recent research has discovered additional promising therapy options. Conclusions: Detecting DRESS syndrome early is crucial to ensure prompt treatment, prevent serious complications, and improve patient outcomes. Healthcare providers should be aware of the signs and symptoms of DRESS syndrome, especially in patients taking particular medications, and be prepared to investigate further if it is suspected

Coeliac disease – systematic review of origin, pathology, diagnosis and treatment

Introduction and Purpose: Coeliac disease is an increasingly prevalent disorder worldwide. It is estimated to affect about 1% of the population and its symptoms heavily impact people's lives. The aim of this paper is to delve into the topic of coeliac disease and present basic information about its origins, current diagnostic methods, and the challenges associated with its treatment. This article includes all the necessary information from up-to-date sources. State of Knowledge: Coeliac disease was discovered a long time ago, but it is still not completely understood. Every year, new research is published regarding different populations in various countries. While we know more about the disease, its symptoms, and causes, we are still far from fully understanding all the inflammatory processes occurring in the human body. There is solid evidence that this enteropathy is caused by gluten, and the only way to reduce the clinical manifestation of coeliac disease is to adhere to a gluten-free diet. However, some patients do not benefit from this type of diet and still suffer from coeliac disease. New drugs currently being developed offer hope for these individuals, as they attempt to target the immunological reaction and mitigate the immune response in the small intestine. Conclusion: As approximately 1% of the population suffers from this disease, it is crucial to diagnose patients in the early stages of its development. Early diagnosis can prevent the development of other disorders that coexist with coeliac disease, which can be particularly dangerous, especially for children. This paper provides up-to-date information about the clinical manifestations of the disease, as well as methods of diagnosis.

Knowledge and learning preferences of patients with myocardial infarction

Introduction. The objective of the research was to study the knowledge about ischaemic heart disease and learning preferences of hospitalised patients as a result of myocardial infarction. Methods. The tested group comprised of 248 patients, aged 63 ± 11.25, who were hospitalised as a result of myocardial infarction A questionnaire with 20 single-choice questions was used in the research. The questionnaire tested the knowledge of the patients as far as ischaemic heart disease, myocardial infarction symptoms, and preventive healthcare are concerned. The patients were divided into groups depending on what knowledge sources on ischaemic heart disease they preferred — brochures, magazines, radio and TV, individual talks, group talks, films, the Internet. Results. The proportion of correct answers was 58.49 ± 19.89%; in the area of the disease knowledge 62.74 ± 31.52%; in the area of the preventive healthcare 57.14 ± 23.38%; and in the area of the disease symptoms 56.94 ± 25.84%. The source of health knowledge selected the most was educational brochures (80.2%), while radio and TV was selected the least (17.6%). The knowledge varied depending on patients’ preferences: so those who selected films — the knowledge of the disease symptoms was higher compared to the others (64.44 ± 26.93% vs. 55.27 ± 25.35%; p = 0.02; those who selected individual talks — the knowledge of the disease symptoms was lower compared to the others (55.33 ± 24.80 vs. 61.68 ± 26.51; p = 0.007); those who selected group talks — the knowledge of the disease symptoms was higher compared to the others (62.30 ± 28.07 vs. 55.16 ± 24.96; p = 0.02). As far the other two areas of knowledge are concerned, there were no significant differences in any group. Conclusions. Educational brochures are the most preferred source of knowledge about ischaemic heart disease by hospitalised patients as a result of myocardial infarction. The knowledge of ischaemic heart disease in patients with myocardial infarction is inadequate and it is not connected with patients’ preferences from the point of view of learning methods.

Knee injuries in volleyball - a review of the articles

Introduction and purpose: The aim of this study is to review and analyze scientific research on the topic of volleyball injuries. We attempt to identify the types of injuries that are characterized by increased frequency, diagnostic possibilities, and treatment methods. We believe that this work can support individuals involved in sports and sports medicine personnel in accessing information more quickly and facilitate the direction of further research into preventing injuries among volleyball players. State of Knowledge: Knee injuries are divided into overload and acute injuries. Overload syndromes include degenerative changes to the patellar ligament. Medical history and physical exam suffice for accurate diagnosis. Treatment for jumper’s knee is based mostly on conservative treatment. Meniscus injuries are equally common such as ACL rupture. Not all meniscus injuries require surgery, and the key factor in making a decision is the pattern of tearing and the presence of appropriate vascularization. Conclusions:  Based on analyzed studies we assumed that every third serious injury among volleyball players is the knee injury. There is no single preferred method of treatment. Early diagnosis and intervention are crucial to prevent the progression of the disease. Stretching and eccentric strengthening exercises are recommended in the early stages. Efficiency of platelet-rich plasma injections remains uncertain. Further research is needed to determine the most effective treatment. In acute knee injuries, ACL damage often coexists. Treatment for such injuries typically involves surgical intervention. Arthroscopy is the preferred method. Meniscus repair has a high success rate and enables a rapid return to physical fitness

Hashimoto’s thyroidits and other causes of hypothyrodisim – systematic review

Introduction and objective: The aim of the study is to summarize the knowledge about hypothyroidism, with particular emphasis on Hashimoto's disease, as its most common cause. Review metods: Literature review of PubMed database using key words contained in ‘Medical Subject Headings’ MeSH.  State of Knowledge: Hashimoto's disease is the most common form of thyroiditis, as well as main cause of hypothyroidism. It is an autoimmune disease that leads to gradual fibrosis and atrophy of the thyroid gland. It occurs several times more frequently in women than in men. Treatment mainly involves supplementation of thyroid hormones due to the progressive hypothyroidism. Levothyroxine (L-T4) therapy has a long history of clinical use, a defined pharmacological profile, and is considered as safe treatment of hypothyroidism of the thyroid gland. There are also other, less common causes of hypothyroidism, such as postoperative hypothyroidism, de Quervain's disease, post-radioactive iodine treatment status, drug-induced and central hypothyroidism, which are equally important and should not be forgotten during the diagnostic process. Summary: Hypothyroidism can be caused by various factors, the main being Hashimoto’s thyroiditis. Regardless of the etiology, treatment in most cases involves levothyroxine (LT-4) supplementation, which leads to euthyroidism and resolution of symptoms. Surgery may need to be performed in pateitns who meet the surgical criteria and show unresponsiveness to conservative treatment