Malacological indicators of anthropogenic and natural environmental changes of the Podhale Basin during the last 2000 years. Studies in the Rogoźnik Stream valley (the Carpathian Mountains, Southern Poland)

The lithological and malacological studies covered sediments forming the low terrace of the Rogoźnik Stream in the northwest part of the Podhale Basin. This terrace is characterised by a uniform structure within a significant part of the valley. Three layers of gravel and four layers of sandy and silty muds were found there. A rich and diversified malacofauna was discovered in fine-grained sediments. Its analysis allowed us to characterise environmental conditions during sediment deposition. The age of the individual components of the sedimentary sequence was determined by radiocarbon dating. A distinct change was found in the upper intervals of the sequence, corresponding to the warm phase of the Medieval Climate Optimum. This period is associated with the robust development of agriculture, and processes related to human activities became the main factor shaping the environment, influencing the course of geological processes, and changing the taxonomical and ecological structure of the fauna and flora assemblages found in this area

Thyroid gland in chronic obstructive pulmonary disease

The risk of chronic obstructive pulmonary disease (COPD), as well as thyroid diseases increases with age. COPD is a common systemic disease associated with chronic inflammation. Many endocrinological disorders, including thyroid gland diseases are related to systemic inflammation. Epidemiological studies suggest that patients with COPD are at higher risk of thyroid disorders. These associations are not well-studied and thyroid gland diseases are not included on the broadly acknowledged list of COPD comorbidities. They may seriously handicap quality of life of COPD patients. Unfortunately, the diagnosis may be difficult, as many signs are masked by the symptoms of the index disease. The comprehension of the correlation between thyroid gland disorders and COPD may contribute to better care of patients. In this review, we attempt to revise available literature describing existing links between COPD and thyroid diseases.The risk of chronic obstructive pulmonary disease (COPD), as well as thyroid diseases increases with age. COPD is a common systemic disease associated with chronic inflammation. Many endocrinological disorders, including thyroid gland diseases are related to systemic inflammation. Epidemiological studies suggest that patients with COPD are at higher risk of thyroid disorders. These associations are not well-studied and thyroid gland diseases are not included on the broadly acknowledged list of COPD comorbidities. They may seriously handicap quality of life of COPD patients. Unfortunately, the diagnosis may be difficult, as many signs are masked by the symptoms of the index disease. The comprehension of the correlation between thyroid gland disorders and COPD may contribute to better care of patients. In this review, we attempt to revise available literature describing existing links between COPD and thyroid diseases

Acute phase proteins and vitamin D seasonal variation in end-stage renal disease patients

: End-stage renal disease (ESRD) patients are vulnerable to vitamin D deficiency due to impaired renal hydroxylation, low dietary intake and inadequate sun exposure. Vitamin D plays a role in innate and adaptive immunity and its seasonal variation has been linked to mortality. ESRD is associated with inadequate removal of pro-inflammatory cytokines regulating acute phase protein (APP) synthesis. Our aim was to look for associations between lifestyle factors, diet, and vitamin D seasonal variation and their relationship with selected APPs and calcium-phosphate metabolism. The study included 59 ESRD patients treated with maintenance hemodialysis. A 24-hour dietary recall was conducted in the post-summer (November 2018, PS) and post-winter (February/March 2019, PW) period, and blood was collected for the measurements of serum total vitamin D, α1-acid glycoprotein (AGP), C-reactive protein (CRP), albumin, prealbumin (PRE), parathormone, calcium and phosphate. A self-constructed questionnaire gathered information on vitamin D supplementation, sun exposure and physical activity. Higher caloric intake was observed PW compared PS. Less than 15% of participants met the dietary recommendations for energy, protein, fiber, vitamin D and magnesium intake. Vitamin D supplementation was associated with higher serum vitamin D regardless of season. AGP, PRE, albumin, and vitamin D presented seasonal changes (higher values PS). In patients with serum vitamin D below 25 ng/mL, vitamin D seasonal change correlated with CRP and prealbumin change. Phosphate and Ca × P correlated positively with AGP. A low vitamin D serum level could impact the inflammatory process; however, more studies are needed to confirm the relationship

Serum soluble fms-like tyrosine kinase 1 (sFlt-1) predicts the severity of acute pancreatitis

Organ failure is the most important determinant of the severity of acute pancreatitis (AP). Soluble fms-like tyrosine kinase 1 (sFlt-1) is positively associated with organ failure in sepsis. Our aim was to evaluate the diagnostic utility of automated sFlt-1 measurements for early prediction of AP severity. Adult patients (66) with AP were recruited, including 46 with mild (MAP), 15 with moderately-severe (MSAP) and 5 with severe AP (SAP). Serum and urine samples were collected twice. Serum sFlt-1 was measured with automated electrochemiluminescence immunoassay. Serum concentrations of sFlt-1 were significantly higher in patients with MSAP and SAP as compared to MAP. SAP patients had the highest concentrations. At 24 and 48 h, sFlt-1 positively correlated with inflammatory markers (leukocyte count, C-reactive protein), kidney function (creatinine, urea, cystatin C, serum and urine neutrophil gelatinase-associated lipocalin, urine albumin/creatinine ratio), D-dimer and angiopoietin-2. sFlt-1 positively correlated with the bedside index of severity in AP (BISAP) score and the duration of hospital stay. Serum sFlt-1 above 139 pg/mL predicted more severe AP (MSAP + SAP). In the early phase of AP, sFlt-1 is positively associated with the severity of AP and predicts organ failure, in particular kidney failure. Serum sFlt-1 may be a practical way to improve early assessment of AP severity

Zaburzenia funkcji tarczycy w przewlekłej obturacyjnej chorobie płuc

Ryzyko zachorowania na przewlekłą obturacyjną chorobę płuc (POChP), podobnie jak ryzyko chorób tarczycy, wzrasta z wiekiem. POChP jest częstą chorobą systemową, związaną z przewlekłym stanem zapalnym. Wiele chorób gruczołów dokrewnych, w tym chorób tarczycy, przebiega z cechami zapalenia systemowego. Wyniki badań epidemiologicznych wskazują na większe ryzyko zachorowania na choroby tarczycy u chorych na POChP. Te związki nie zostały dotychczas dobrze zbadane, a choroby tarczycy nie są powszechnie uznawane za częste współchorobowości POChP. Choroby tarczycy mogą negatywnie wpływać na jakość życia chorych na POChP. Ich rozpoznanie może być trudne, ponieważ kluczowe objawy są maskowane przez symptomy choroby podstawowej. Lepsze poznanie związków pomiędzy chorobami tarczycy a POChP może się przyczynić do poprawy efektów leczenia chorych na POChP. W niniejszej pracy dokonano przeglądu literatury poświęconej związkom pomiędzy POChP i chorobami tarczycy.Ryzyko zachorowania na przewlekłą obturacyjną chorobę płuc (POChP), podobnie jak ryzyko chorób tarczycy, wzrasta z wiekiem. POChP jest częstą chorobą systemową, związaną z przewlekłym stanem zapalnym. Wiele chorób gruczołów dokrewnych, w tym chorób tarczycy, przebiega z cechami zapalenia systemowego. Wyniki badań epidemiologicznych wskazują na większe ryzyko zachorowania na choroby tarczycy u chorych na POChP. Te związki nie zostały dotychczas dobrze zbadane, a choroby tarczycy nie są powszechnie uznawane za częste współchorobowości POChP. Choroby tarczycy mogą negatywnie wpływać na jakość życia chorych na POChP. Ich rozpoznanie może być trudne, ponieważ kluczowe objawy są maskowane przez symptomy choroby podstawowej. Lepsze poznanie związków pomiędzy chorobami tarczycy a POChP może się przyczynić do poprawy efektów leczenia chorych na POChP. W niniejszej pracy dokonano przeglądu literatury poświęconej związkom pomiędzy POChP i chorobami tarczycy

The diagnostic usefulness of serum total bile acid concentrations in the early phase of acute pancreatitis of varied etiologies

The most common causes of acute pancreatitis (AP) are biliary tract diseases with cholestasis and alcohol consumption. In 10%–15% of patients, etiology determination is difficult. Identification of the etiology allows for the implementation of adequate treatment. The aim of this study was to assess the utility of the serum concentrations of total bile acids (TBA) to diagnose AP etiology in the early phase of the disease. We included 66 patients with AP, admitted within the first 24 h from the onset of symptoms. TBA were measured in serum at 24, 48, and 72 h from the onset of AP, using an automated fifth generation assay. The bilirubin-to-TBA ratio (B/TBA) was calculated. TBA was highest on the first day of AP and decreased subsequently. In patients with biliary etiology, serum TBA was significantly higher compared to those with alcoholic and other etiologies. B/TBA was significantly higher in patients with alcoholic etiology. At admission, the cut-off values of 4.7 µmol/L for TBA and 4.22 for the B/TBA ratio allowed for a differentiation between biliary and other etiologies of AP with a diagnostic accuracy of 85 and 83%. Both TBA and B/TBA may help in the diagnosis of AP etiology in the early phase of AP

Serum concentrations of angiopoietin-2 and soluble fms-like tyrosine kinase 1 (sFlt-1) are associated with coagulopathy among patients with acute pancreatitis

In severe acute pancreatitis (SAP), systemic inflammation leads to endothelial dysfunction and activation of coagulation. Thrombotic disorders in acute pancreatitis (AP) include disseminated intravascular coagulation (DIC). Recently, angiopoietin-2 and soluble fms-like tyrosine kinase 1 (sFlt-1) were proposed as markers of endothelial dysfunction in acute states. Our aim was to assess the frequency of coagulation abnormalities in the early phase of AP and evaluate the relationships between serum angiopoietin-2 and sFlt-1 and severity of coagulopathy. Sixty-nine adult patients with AP were recruited: five with SAP, 15 with moderately severe AP (MSAP) and 49 with mild AP. Six patients were diagnosed with DIC according to International Society on Thrombosis and Haemostasis (ISTH) score. All patients had at least one abnormal result of routine tests of hemostasis (low platelet count, prolonged clotting times, decreased fibrinogen, and increased D-dimer). The severity of coagulopathy correlated with AP severity according to 2012 Atlanta criteria, bedside index of severity in AP and duration of hospital stay. D-dimers correlated independently with C-reactive protein and studied markers of endothelial dysfunction. Angiopoietin-2, D-dimer, and ISTH score were best predictors of SAP, while sFlt-1 was good predictor of MSAP plus SAP. In clinical practice, routine tests of hemostasis may assist prognosis of AP

Malnutrition, inflammation, atherosclerosis syndrome (MIA) and diet recommendations among end-stage renal disease patients treated with maintenance hemodialysis

Malnutrition-inflammation-atherosclerosis syndrome is one of the causes of increased mortality in chronic kidney disease (CKD). The aim of the study was to assess the inflammation and nutritional status of patients in end-stage kidney disease treated with maintenance hemodialysis. The study included a group of 98 hemodialyzed patients with stage 5 CKD (38 women and 60 men). Albumin, prealbumin (PRE), and C-reactive protein (CRP) were measured in serum samples collected before mid-week dialysis. Fruit and vegetables frequency intakes were assessed with a questionnaire. CRP was above the reference limit of 5 mg/L in 53% of patients. Moreover, the Glasgow Prognostic Score (GPS) indicated the co-occurrence of inflammation and protein calorie malnutrition in 11% of patients, and the presence of either inflammation or malnutrition in 25%. The questionnaire revealed that hemodialyzed patients frequently exclude fruit and vegetables from their diets. Nearly 43% of the interviewed patients declared frequently eating vegetables, and 35% declared frequently eating fruit, a few times per week or less. The most frequently selected fruit and vegetables had a low antioxidant capacity. The strict dietary restrictions in CKD are difficult to fulfill, and if strictly followed, may lead to protein-calorie malnutrition