Troska o zdrowie w aspekcie społecznym. Cz. 2

Praca recenzowana / peer-reviewed pape

Przewlekłe zapalenie pęcherza moczowego typu cystitis cystica u dzieci

Background. Infections of the urinary tract are the second most common bacterial infections occurring among the pediatric population. Cystitis cystica is the prevalent form of chronic inflammation which occurs in children. The pathogenesis of the disease is unclear, however recurrent urinary tract infections are considered to be the most common cause. Inflammation may be asymptomatic or present with symptoms of active infection. Chronic inflammation can lead to micturition disorders. Treatment of cystitis cystica is difficult and long-lasting. Here, the authors present their experience on the diagnosis and treatment of patients with cystitis cystica.Material and methods. In the period 2016-2019, 871 cystoscopies were performed at the Department of Pediatric Surgery and Pediatric Urology of the Centre of Postgraduate Medical Education, Warsaw, Poland. Depending on the severity of macroscopic changes, the severity of symptoms, and the occurrence of recurrent urinary tract infections, different treatment protocols were used: oral administration of furazidine and trimethoprim with sulfamethoxazole, intravesical instillation of gentamicin and immunomodulating treatment in chosen cases.Results. Improvement in the clinical condition of sick children was achieved in 79% of patients (84/106). Changes in endoscopic findings did not always correlate with clinical symptoms.Conclusions. The authors recommend extended diagnostics to include endoscopic examination in children with recurrent bladder infections and/or voiding disorders that are difficult to treat. This will allow exclusion or diagnosis of cystitis cystica and enable appropriate treatment at the initial stage of the disease, making regression of the changes in the bladder mucosa possible with oral pharmacotherapy only.Wprowadzenie. Zakażenia układu moczowego zajmują drugie miejsce wśród wszystkich infekcji bakteryjnych w populacji dziecięcej. Cystitis cystica jest najczęstszą formą przewlekłego zapalenia pęcherza moczowego u dzieci. Patogeneza choroby jest niejasna, jednakże uważa się, że najczęstszą przyczyną są nawracające zakażenia układu moczowego. Zapalenie może być bezobjawowe lub przebiegać w formie aktywnej infekcji i wywoływać zaburzenia mikcji. Leczenie zmian o typie cystitis cystica jest trudne i długotrwałe. Autorzy przedstawiają własne doświadczenia dotyczące diagnostyki i leczenia pacjentów z cystitis cystica. Materiał i metody. W latach 2016-2019 w Klinice Chirurgii Dziecięcej i Urologii Dziecięcej Centrum Medycznego Kształcenia Podyplomowego w Warszawie wykonano 871 cystoskopii. W zależności od stopnia nasilenia zmian makroskopowych, nasilenia dolegliwości, oraz występowania nawracających zakażeń układu moczowego, stosowano różne protokoły leczenia obejmujące leczenie doustne furazydyną i trimetoprimem z sulfametoksazolem, leczenie miejscowe wlewkami dopęcherzowymi gentamycyny, oraz leczenie immunomodulujące u wybranych pacjentów. Wyniki. Poprawę stanu klinicznego chorych dzieci uzyskano u 79% pacjentów (84/106). Zmiany w obrazie endoskopowym nie zawsze korelowały z objawami klinicznymi. Wnioski. Autorzy uważają za celowe poszerzenie diagnostyki u pacjentów z nawracającymi zakażeniami pęcherza moczowego i/lub zaburzeniami mikcji trudno poddającymi się leczeniu, o badania endoskopowe. Pozwolą one wykluczyć bądź rozpoznać cystitis cystica i włączyć odpowiednie leczenie w początkowym okresie choroby, umożliwiając regresję zmian błony śluzowej pęcherza moczowego przy zastosowaniu jedynie farmakoterapii doustnej

The Effect of Mineral Salt on Reactive Dye Removal from Aqueous Solutions by Ultrafiltration

The effect of mineral salt on the reactive dye removal was evaluated by using flat ultrafiltration (UF) membranes made of polyethersulfone (PES) and regenerated cellulose (C). Five reactive dyes varied in molecular weight (Reactive Orange 16, Remazol Brilliant Blue R, Reactive Orange 20, Reactive Black 5, Reactive Read 120) were used in the UF experiments. The applied membranes were characterized by the cut-off value equal to 10 kDa. The ultrafiltration process was performed in a dead-end mode under the transmembrane pressure of 0.2 MPa. Dye concentration in model solutions was equal to 100 mg/dm3. Two various mineral salts (NaCl and Na2SO4) were chosen to simulate the composition of dye-house baths. The concentration of monovalent and divalent salt in model dye solutions amounted to 1–2 g/dm3. Transport and separation properties of the UF membranes towards reactive dyes and mineral salts were evaluated. It was found that the separation efficiency of all tested dyes was dependent on the mineral salt presence. The effect of mineral salt on dye retention was more pronounced for membrane made of regenerated cellulose (C) than for polyethersulfone membrane (PES). In the case of the C membrane the dye retention coefficients varied in the wide range – from 55 to 83%, whereas for PES membrane the degree of dye separation was less diverse and amounted to 81–96%. The presence of mineral salt in water and dye solutions generally worsen the membrane permeability due to osmotic pressure increase as well as enhancing adsorptive fouling of dye particles in membrane matrix

Altered Expression Levels of MMP1, MMP9, MMP12, TIMP1, and IL-1 as a Risk Factor for the Elevated IOP and Optic Nerve Head Damage in the Primary Open-Angle Glaucoma Patients

The aim of presented work was to analyze the impact of particular polymorphic changes in the promoter regions of the -1607 1G/2G MMP1, -1562 C/T MMP9, -82 A/G MMP12, -511 C/T IL-1β, and 372 T/C TIMP1 genes on their expression level in POAG patients. Blood and aqueous humor samples acquired from 50 patients with POAG and 50 control subjects were used for QPCR and protein levels analysis by ELISA. In vivo promoter activity assays were carried on HTM cells using dual luciferase assay. All studied subjects underwent ophthalmic examination, including BCVA, intraocular pressure, slit-lamp examination, gonioscopy, HRT, and OCT scans. Patients with POAG are characterized by an increased mRNA expression of MMP1, MMP9, MMP12, and IL-1β genes as compared to the control group (P<0.001). Aqueous humor acquired from patients with POAG displayed increased protein expression of MMP1, MMP9, MMP12, and IL-1β compared to the control group (P<0.001). Allele -1607 1G of MMP1 gene possesses only 42,91% of the -1607 2G allele transcriptional activity and allele -1562 C of MMP9 gene possesses only 21,86% of the -1562 T allele. Increased expression levels of metalloproteinases can be considered as a risk factor for the development of POAG

Analysis of the Expression and Polymorphism of APOE, HSP, BDNF, and GRIN2B Genes Associated with the Neurodegeneration Process in the Pathogenesis of Primary Open Angle Glaucoma

Glaucoma is characterized by optic neuropathy of the RGC or retinal nerve fiber. The aim of this study was to evaluate a relationship between the neurodegenerative genes&apos; polymorphisms of the APOE (rs449647), BDNF (rs2030324), GRIN2B (rs3764028), and HSP70-1 (rs1043618) and the occurrence risk of POAG and to investigate its effect on allele-specific gene expression. Genomic DNA was extracted from peripheral blood. Analysis of the genes&apos; polymorphisms was performed using PCR-RFLP. The level of mRNA expression was determined by QRT-PCR. We showed a statistically significant association of BDNF and APOE genes&apos; polymorphisms with a risk of POAG occurrence. There was a statistically significant association of the rs2030324 polymorphism with progression of POAG based on cup disc ratio value and rs1043618 polymorphism based on nerve fiber index and rim area. Furthermore, we found that mean HSP70-1 mRNA expression was significantly lower in the case of individuals with the G/G genotype than in the case of minor allele carriers, that is, G/C and C/C. We also found that BDNF and HSP70-1 expression level are associated with the progression of POAG based on rim area value. In conclusion, our results suggest that BDNF, APOE, and HSP70-1 genes might be associated with a risk of POAG occurrence in the Polish population

Gene Expression-Based Functional Differences between the Bladder Body and Trigonal Urothelium in Adolescent Female Patients with Micturition Dysfunction

The aim of this study is to determine the molecular differences between the urothelial transcriptomes of the bladder body and trigone. The transcriptomes of the bladder body and trigonal epithelia were analyzed by massive sequencing of total epithelial RNA. The profiles of urothelial and urinal microbiomes were assessed by amplicon sequencing of bacterial 16S rRNA genes in 17 adolescent females with pain and micturition dysfunction and control female subjects. The RNA sequencing identified 10,261 differentially expressed genes (DEGs) in the urothelia of the bladder body and trigone, with the top 1000 DEGs at these locations annotated to 36 and 77 of the Reactome-related pathways in the bladder body and trigone, respectively. These pathways represented 11 categories enriched in the bladder body urothelium, including extracellular matrix organization, the neuronal system, and 15 categories enriched in the trigonal epithelium, including RHO GTPase effectors, cornified envelope formation, and neutrophil degranulation. Five bacterial taxa in urine differed significantly in patients and healthy adolescent controls. The evaluation of their transcriptomes indicated that the bladder body and trigonal urothelia were functionally different tissues. The molecular differences between the body and trigonal urothelia responsible for clinical symptoms in adolescents with bladder pain syndrome/interstitial cystitis remain unclear

Variability in the Clinical Course of COVID-19 in a Retrospective Analysis of a Large Real-World Database

The COVID-19 pandemic proceeds in waves, with variable characteristics of the clinical picture resulting from the evolution of the SARS-CoV-2 virus. This study aimed to compare the epidemiological characteristics, symptomatology, and outcomes of the disease in patients hospitalized for COVID-19 during periods of different variants dominance. Comparing the periods of dominance of variants preceding the Delta variant, the Delta period was characterized by a higher share of hospitalized females, less frequent comorbidities among patients, and a different age distribution. The lowest need for oxygen therapy and mechanical ventilation was observed under Omicron dominance. The triad of classic COVID-19 symptoms, cough, fever, dyspnoea, and fatigue, were most prevalent during the Delta period, and significantly less common under the Omicron dominance. During the Omicron period, nearly twice as many patients as in the previous periods could be discharged from the hospital within 7 days; the overall 28-day mortality was significantly lower compared to that of the Delta period. It also did not differ between periods that were dominated by the BA.1 and BA.2 subvariants. The study indicates that the Omicron SARS-CoV-2 variant that dominated between January and June 2022 caused a disease which resembled the common cold, and was caused by seasonal alpha and beta-coronaviruses with a low pathogenicity for humans. However, one should note that this effect may not only have been related to biological features of the Omicron lineage, but may additionally have been driven by the increased levels of immunization through natural infections and vaccinations, for which we could not account for due to a lack of sufficient data

What is a good argument? : the method of expert discourse in argumentation research

Artykuł przedstawia Metodę Dyskursu Eksperckiego wraz z opisem jej praktycznego zastosowania w środowisku naukowym Polskiej Szkoły Argumentacji. Metoda opracowana została z myślą o zorganizowaniu skutecznej współpracy między specjalistami tej samej dziedziny. Na kolejne etapy składają się: sondaż wśród ekspertów, mający wyłonić stanowiska, wybranie na jego podstawie najważniejszych oraz najbardziej kontrowersyjnych kwestii, przedyskutowanie ich w grupach i poddanie analizie za pomocą narzędzia OVA+. Artykuł zawiera sprawozdanie z pracy nad zagadnieniem siły argumentu, mającym szczególne znaczenie dla programu badań w Polskiej Szkole Argumentacji.The article presents the Method of Expert Discourse, and a description of its practical application within the scientifi c community of the Polish School of Argumentation. The method was developed in order to effectively organize collaboration among specialists working in the same fi eld of investigation. The application of the method consists of the following stages: carrying out a survey addressed to experts, which is to reveal main positions; and, on this basis, selecting of some most important and controversial issues, and fi nally discussing them in groups and analyzing with help of OVA+, a tool for argument processing. The article contains a report on the research into the issue of argument force, which has a particular signifi cance for the research program of the Polish School of Argumentation