Wyprysk atopowy jako jeden z objawów alergii pokarmowej u dzieci

Wyprysk atopowy jest częstym objawem klinicznym alergii pokarmowej u niemowląt i dzieci. Białka mleka krowiego są głównym alergenem odpowiedzialnym za objawy wyprysku, zarówno u dzieci karmionych naturalnie, jak i sztucznie. Metodą referencyjną służącą do wykrycia związku przyczynowo-skutkowego między spożywanym pokarmem a objawami klinicznym jest próba prowokacji metodą podwójnie ślepej próby kontrolowanej placebo. Głównym postępowaniem leczniczym jest czasowa eliminacja szkodliwego pokarmu. Wybór leczenia farmakologicznego zależy od ciężkości zapalenia skóry. Polega przede wszystkim na właściwej pielęgnacji skóry oraz miejscowej lub ogólnej farmakoterapii. Forum Medycyny Rodzinnej 2010, tom 4, nr 3, 181-18

Withdrawal from bariatric treatment – an analysis under various demographic conditions

Introduction Poland is high on a list of countries affected by epidemics of obesity, a problem that has especially suddenly increased in the post-transformation period. Material and Methods Documentation of 115 subsequent patients diagnosed with grade 3 obesity, considered eligible for surgical treatment, was analysed since 2015. A subgroup of 68 patients was selected from this group and the included patients who decided to cancel their treatment at various stages. Their history since presentation at the obesity treatment centre, BMI with its history, age, education and place of residence were analysed, followed by a telephone survey. 42 patients were finally contacted. Special attention was placed on the analysis of patients taking into account their place of residence. Patients were divided into inhabitants of rural and urban areas. Results In the study group of 68 patients, 19 (27.9%) were inhabitants of rural areas and 49 (72.1%) of urban areas. Women accounted for 67.6%, and men for 32.4%. The mean age of patients when they presented for treatment was 43 years. On average, men presented 5 years later compared to women. The mean BMI on qualification for treatment of obesity was 47.6 kg/m 2 . The mean BMI max – 49.6 kg/m 2 . There were no differences regarding education in both populations. Despite the lack of differences regarding changes in the BMI since withdrawal from treatment, as many as 63% of patients from rural areas reached the BMI max in this time. Conclusions There were demographic differences between the degree of obesity observed among patients receiving bariatric treatment, and inhabitants of urban areas were favoured. Patients from rural areas who withdrew from bariatric treatment and were left without medical care significantly more often achieved their maximum body weight, when compared to those living in urban areas. The active participation of physicians, both specialists and general practitioners, in the life of obese patients is imperative

Withdrawal from bariatric treatment – an analysis under various demographic conditions

Introduction Poland is high on a list of countries affected by epidemics of obesity, a problem that has especially suddenly increased in the post-transformation period. Material and Methods Documentation of 115 subsequent patients diagnosed with grade 3 obesity, considered eligible for surgical treatment, was analysed since 2015. A subgroup of 68 patients was selected from this group and the included patients who decided to cancel their treatment at various stages. Their history since presentation at the obesity treatment centre, BMI with its history, age, education and place of residence were analysed, followed by a telephone survey. 42 patients were finally contacted. Special attention was placed on the analysis of patients taking into account their place of residence. Patients were divided into inhabitants of rural and urban areas. Results In the study group of 68 patients, 19 (27.9%) were inhabitants of rural areas and 49 (72.1%) of urban areas. Women accounted for 67.6%, and men for 32.4%. The mean age of patients when they presented for treatment was 43 years. On average, men presented 5 years later compared to women. The mean BMI on qualification for treatment of obesity was 47.6 kg/m 2 . The mean BMI max – 49.6 kg/m 2 . There were no differences regarding education in both populations. Despite the lack of differences regarding changes in the BMI since withdrawal from treatment, as many as 63% of patients from rural areas reached the BMI max in this time. Conclusions There were demographic differences between the degree of obesity observed among patients receiving bariatric treatment, and inhabitants of urban areas were favoured. Patients from rural areas who withdrew from bariatric treatment and were left without medical care significantly more often achieved their maximum body weight, when compared to those living in urban areas. The active participation of physicians, both specialists and general practitioners, in the life of obese patients is imperative

PG 2 2009.qxp

H Hy yp po op ph ho os sp ph ha at ta ae em mi ia a a as s a an n e el le em me en nt t o of f ' 'r re ef fe ee ed di in ng g s sy yn nd dr ro om me e' ' --a a c co om mp pl li ic ca at ti io on n o of f n nu ut tr ri it ti io on na al l t tr re ea at tm me en nt t i in n a an n e ex xt tr re em me el ly y n ne eg gl le ec ct te ed d 5 5--y ye ea ar r--o ol ld d g gi ir rl l w wi it th h i in nf fa an nt ti il le e c ce er re eb br ra al l p pa al ls sy y Hipofosfatemia jako jeden z elementów zespo³u refeeding -powik³anie leczenia ¿ywieniowego u skrajnie zaniedbanej 5-letniej dziewczynki z mózgowym pora¿eniem dzieciêcym K Ke ey y w wo or rd ds s: : refeeding syndrome, children, malnutrition. S Sł ło ow wa a k kl lu uc cz zo ow we e: : zespół ponownego odżywiania, dzieci, niedożywienie. A Ad dd dr re es ss s f fo or r c co or rr re es sp po on nd de en nc ce e

Physiological Hypoxia (Physioxia) Impairs the Early Adhesion of Single Lymphoma Cell to Marrow Stromal Cell and Extracellular Matrix. Optical Tweezers Study

Adhesion is critical for the maintenance of cellular structures as well as intercellular communication, and its dysfunction occurs prevalently during cancer progression. Recently, a growing number of studies indicated the ability of oxygen to regulate adhesion molecules expression, however, the influence of physiological hypoxia (physioxia) on cell adhesion remains elusive. Thus, here we aimed: (i) to develop an optical tweezers based assay to precisely evaluate single diffuse large B-cell lymphoma (DLBCL) cell adhesion to neighbor cells (mesenchymal stromal cells) and extracellular matrix (Matrigel) under normoxia and physioxia; and, (ii) to explore the role of integrins in adhesion of single lymphoma cell. We identified the pronouncedly reduced adhesive properties of lymphoma cell lines and primary lymphocytes B under physioxia to both stromal cells and Matrigel. Corresponding effects were shown in bulk adhesion assays. Then we emphasized that impaired β1, β2 integrins, and cadherin-2 expression, studied by confocal microscopy, account for reduction in lymphocyte adhesion in physioxia. Additionally, the blockade studies conducted with anti-integrin antibodies have revealed the critical role of integrins in lymphoma adhesion. To summarize, the presented approach allows for precise confirmation of the changes in single cell adhesion properties provoked by physiological hypoxia. Thus, our findings reveal an unprecedented role of using physiologically relevant oxygen conditioning and single cell adhesion approaches when investigating tumor adhesion in vitro

Fat-free mass at admission predicts 28-day mortality in intensive care unit patients: the international prospective observational study Phase Angle Project

International audiencePurpose: Phase angle as measured by bioelectrical impedance analysis reflects fat-free mass. Fat-free mass loss relates to worse prognosis in chronic diseases. Primary aim of this study was: to determine the association between fat-free mass at intensive care unit admission and 28-day mortality. Methods: Ten centres in nine countries participated in this multicentre prospective observational study. The inclusion criteria were age >18 years; expected length of stay >48 h; absence of pacemaker, heart defibrillator implant, pregnancy and lactation. Fat-free mass was assessed by measurement of the 50-kHz phase angle at admission. The primary endpoint was 28-day mortality. The area under the receiver operating characteristic curve (AUC) was used to assess prediction of 28-day mortality by fat-free mass at ICU admission. The variables associated with 28-day mortality were analysed by means of multivariable logistic regression. Results: Of the 3605 patients screened, 931 were analysed: age 61 ± 16 years, male 60 %, APACHE II 19 ± 9, body mass index 26 ± 6, day 1 phase angle 4.5° ± 1.9°. Day 1 phase angle was lower in patients who eventually died than in survivors (4.1° ± 2.0° vs. 4.6° ± 1.8°, P = 0.001). The day 1 phase angle AUC for 28-day mortality was 0.63 [0.58–0.67]. In multivariable analysis, the following were independently associated with 28-day mortality: age (adjusted odds ratio (aOR) 1.014 [95 % confidence interval 1.002–1.027], P = 0.03), day 1 phase angle (aOR 0.86 [0.78–0.96], P = 0.008), APACHE II (aOR 1.08 [1.06–1.11], P < 0.001), surgical patient (aOR 0.51 [0.33–0.79], P = 0.002), and admission for other diagnosis (aOR 0.39 [0.21–0.72], P = 0.003). A multivariable combined score improved the predictability of 28-day mortality: AUC = 0.79 [0.75–0.82]. Conclusion: Low fat-free mass at ICU admission is associated with 28-day mortality. A combined score improves mortality predictability. Trial registration: NCT01907347 (http://www.clinicaltrials.gov). © 2016, Springer-Verlag Berlin Heidelberg and ESICM