The diagnostic and therapeutic difficulties in management with pheochromocytoma in pregnancy – a review

Introduction: Pheochromocytoma (PCC) is a very rare and life-threatening condition in pregnancy. According to different data, it occurs in about 0,00002%-0,007% of pregnant women. The early diagnosis and the proper clinical management play a crucial role in decreasing maternal and fetal mortality. Aim of the study: This article summarizes the current knowledge about the management with PCC in pregnancy and presents the possible maternal and fetal outcomes. Description of knowledge: The review revealed, that manifestations of catecholamine-secreting tumors are similar to the most common hypertension-associated problems occurring in pregnancy, such as pre-eclampsia. That is why, timely diagnosis is essential for the mothers and fetuses’ survivals. Despite the fact, that the fetus is protected from influence of maternal overproduction of catecholamines due to the presence of placental enzymes activity, there is an enormous risk of spontaneous abortion, fetal growth restriction, premature delivery, when the optimal therapy will not be applied on time. The diagnosis is based on laboratory tests – determination of plasma and urine concentration of catecholamines and imaging tests to localize the tumor, from which only MRI, in 1st and 3rd trimester, and ultrasound examination can be safely used in pregnancy. The guidelines suggest surgical tumor removal as the treatment of choice for women with PCC in pregnancy. The 2nd trimester seems to be the best period for the surgery, however it can be performed only after 10-14 days of effective therapy with alfa- and beta-blockers. The review of literature revealed that, surgical tumor removal carried out before the end of 24. hbd, is safe both for mother and her fetus life. Conclusions: PCC is a great challenge, because of the extremely rare occurrence in pregnant women and serious complications due to the secretion of catecholamines, which may result in catecholamin crisis, increasing the risk of mortality. Nevertheless, there is still no clear consensus on PCC treatment and further researches are needed to develop the optimal management in this clinical condition

Genetic variation in the population of three Polish cattle breeds included into the programme of genetic resources protection and Holstein-Friesian breed, estimation on the basis of polymorphism of 24 microsatellite DNA sequences

The study focused on determining and characterizing genetic variation of three Polish cattle breeds [Whiteback (WB), Polish Red (PR) and Polish Black-and-White (PBW)] included in the programme of genetic resources conservation. The obtained results were related to the genetic variation within the Holstein-Friesian (PHF) breed of Black-and-White variety. Overall, 214 alleles were identified within four examined breeds, including 189 in WB, 178 in PR, 168 in PBW and 158 in PHF. Almost 13% of the identified alleles were the specific ones and the majority of them were determined within WB and PR cattle, 10 alleles in each breed. The greatest genetic distance of 0.013 was established between PR breed and PHF. PR and WB cattle were located in the same clad of neighbour-joining tree which proves their distinction from PBW and PHF cattle.Keywords: Local cattle breeds, genetic variation, microsatellite

Matrix metalloproteinases and their tissue inhibitors as novel markers in invasive pituitary adenomas – a review

Introduction: Pituitary adenomas are generally benign central nervous system neoplasms with still increasing prevalence, especially in younger people. According to the recent data, approximately 30-45% of them invade the local structures, which make their total resection impossible and result in high recurrence rate. Despite the huge advances in management with pituitary tumors, there are no universal biomarkers predicting their course. That is why, the two-way relationship between matrix metalloproteinases (MMPs) activities and the microenvironment of pituitary adenomas is an important object of extensive studies. Aim of the study: This article summarizes the current knowledge about selected MMPs and their tissue inhibitors (TIMPs) in tumorigenesis of pituitary adenomas as well as their role in local invasion in different hormonally active and inactive pituitary tumors. Description of knowledge: MMPs are a family of zinc-dependent proteolytic enzymes, which are engaged in various physiological and pathological conditions. So far, their role in different malignancies have been known for many years. Nevertheless, the possible effects of MMPs and TIMPs in pituitary adenomas are not fully understood. Recent studies suggested that MMPs’ expression is significantly higher in invasive pituitary tumors as compared to non-invasive pituitary adenomas, while the expression of TIMPs is decreased, which may prove their involving in tumorigenesis. Conclusions: MMPs may be predictive factors of the invasiveness and the higher recurrence rate in the group of patients with pituitary adenomas. Understanding the changes in the MMPs-TIMPs system and discovering of its exact mechanisms may result in applying novel screening options as well as modifying diagnostic process and treatment scheme. Therefore, further researches are required to determine the effects of MMPs and TIMPs and their role in the pathogenesis of invasive pituitary tumors

Hashimoto’s encephalopathy – an up-to-date overview

Introduction: Hashimoto’s encephalopathy (HE) is a rare, potentially life-threatening disease with a wide spectrum of clinical manifestations from slight symptoms to mainly neurological and psychiatric syndromes, which significantly debilitate the quality of life and make the diagnostic process complicated, especially in patients with no previous history of thyroid disorders. According to the recent data, it occurs in about 2.1 cases per 100 000 population with still increasing prevalence. Despite, over than fifty years have passed since the first case of HE was reported, its etiopathogenesis is not completely clarify and there is no universal diagnostic criteria. Aim of the study: This article summarizes the current knowledge about pathophysiology, clinical manifestations, difficulties in differential diagnosis and therapeutic dilemmas in patients with HE. Description of knowledge: HE is an autoimmune-mediated encephalopathy associated with Hashimoto’s disease and elevated titers of anti-thyroid antibodies, mainly anti-thyroid peroxidase antibody. The diagnostic process is usually multi-step due to various diseases mimicking HE, such as Creutzfeldt-Jacob disease, brain tumors, epilepsy, Alzheimer's disease, stroke, other forms of autoimmune encephalitis, schizophrenia, spontaneous cerebrospinal fluid leak or infectious encephalitis. The range of diagnostic procedures includes physical and mental examination, laboratory tests, brain imaging, EEG as well as cerebrospinal fluid analysis. However, the first line strategy based on steroids is effective, there are some cases in the literature that reveal this management as not fully sufficient, because only partial improvement was achieved or the steroid-dependence was observed. Among other therapeutic methods, plasmapheresis may be used additionally. Conclusions: HE requires interdisciplinary approach and it constitutes a great challenge for clinicians of various specialties, such as endocrinologists, neurologists, and psychiatrists. The prompt implementation of adequate therapy usually provides the full recovery of the patients without any early or late complications

The role of gut microbiota in patients with autoimmune thyroid diseases – current status and future perspectives

Introduction: Autoimmune diseases constitute a significant clinical problem, due to the increasing incidence, that is why the potential causes that determine their occurrence are sought. Intestinal microbiota greatly outnumber the all of human body’s cells. Its metabolic activity and disorders in the structure, resulting from, for example, antibiotic therapy, lead to homeostasis dysregulation, and in this way gain a new meaning in the etiology of autoimmune diseases. Aim of the study: This article summarizes the current knowledge about gut microbiota in patients with autoimmune thyroid diseases as well as discussed the alterations in the gut microbiota and their potential relationship with thyroid cancer. Description of knowledge: The analyzed scientific literature revealed a relationship between the occurrence of autoimmune diseases and intestinal flora disorders. It is believed that the microbiota that colonized the entire human body, due to diversity, co-formation of the intestinal barrier, its own metabolic activity and participation in many metabolic processes, plays an important role in regulating the immune system functioning. Many data indicate, that the changes in the composition of the intestinal flora in many autoimmune diseases can also be influenced by individual factors, environmental conditions, genetic predisposition, and diet. Conclusions: Gut microbiota is an important element of the immune system and due to the demonstrated changes in its composition in various disease processes and its significant effects on metabolism, the researchers are still underway to clarify all pathogenetic mechanisms of microbiota influencing human homeostasis. Therefore, further studies are required to determine the effect of microbiota and its role in the pathogenesis of autoimmune diseases

Multiple myeloma during pregnancy as a challenge in clinical practice – a review

Introduction: Multiple myeloma (MM) is a hematological malignancy characterized by an abnormal proliferation and accumulation of monoclonal plasma cells. MM typically affects the elderly people with the median age at the diagnosis between 65 to 74 years. Only in < 2% of cases it is observe

Impact of brain parcellation on prediction performance in models of cognition and demographics

Brain connectivity analysis begins with the selection of a parcellation scheme that will define brain regions as nodes of a network whose connections will be studied. Brain connectivity has already been used in predictive modelling of cognition, but it remains unclear if the resolution of the parcellation used can systematically impact the predictive model performance. In this work, structural, functional and combined connectivity were each defined with five different parcellation schemes. The resolution and modality of the parcellation schemes were varied. Each connectivity defined with each parcellation was used to predict individual differences in age, education, sex, executive function, self-regulation, language, encoding and sequence processing. It was found that low-resolution functional parcellation consistently performed above chance at producing generalisable models of both demographics and cognition. However, no single parcellation scheme showed a superior predictive performance across all cognitive domains and demographics. In addition, although parcellation schemes impacted the graph theory measures of each connectivity type (structural, functional and combined), these differences did not account for the out-of-sample predictive performance of the models. Taken together, these findings demonstrate that while high-resolution parcellations may be beneficial for modelling specific individual differences, partial voluming of signals produced by the higher resolution of the parcellation likely disrupts model generalisability

Usporedba proteina sirutke i liposolubilnih vitamina između četiri pasmine krava držane u intenzivnim sustavima proizvodnje

The aim of the study was to determine the content of whey proteins and fat-soluble vitamins in milk samples of four cow breeds maintained in Poland, i.e. Holstein-Friesian, Montbéliarde, Jersey and Simmental. Qualitative and quantitative analyses of certain whey protein fractions, i.e. α-lactalbumin (α-La), β-lactoglobulin (β-Lg), bovine albumin serum (BSA), lactoferrin and lysozyme, and lipophilic vitamins (A, D3 and E) were performed using a RP-HPLC method. According to the obtained results, the breed of cow significantly affected the level of whey proteins and lipophilic vitamins in milk. The lowest amounts of these nutrients were found in milk produced by the Holstein-Friesian cows. Milk of Simmental cows contained the statistically significant and highest levels of antioxidant substances, i.e. vitamins A - 0.465 mg L-1, E - 1.302 mg L-1 and D3 - 0.653 µg L-1 at P≤0.05, as well as β-lactoglobulin (3.28 g L-1 at P≤0.01). In addition, Simmental cow milk was also characterized by higher content of antimicrobial proteins - lactoferrin and lysozyme (respectively: 121.23 mg x L-1 at P≤0.01 and 9.66 µg x L-1 at P≤0.05) if compared with other cow breeds.Cilj ovog istraživanja bio je odrediti sadržaj proteina sirutke i vitamina topljivih u mastima u uzorcima mlijeka za četiri pasmine krava koje se uzgajaju u Poljskoj, t.j. holstein-frizijske, Montbéliarde, Jersey i simentalske. Kvalitativna i kvantitativna analiza određenih frakcija proteina sirutke, odnosno α-laktalbumina (α-La), β-laktoglobulina (β-Lg), albumina goveđeg seruma (BSA), laktoferina i lizozima te liposolubilnih vitamina (A, D3 i E) provedena je pomoću metode RP-HPLC. Prema dobivenim rezultatima, pasmina krava značajno je utjecala na razinu proteina sirutke i liposolubilnih vitamina u mlijeku. Najniže količine tih hranjivih tvari utvrđene su u mlijeku kojeg su proizvele krave pasmine holstein-friesian. Mlijeko simentalskih krava sadržavalo statistički najznačajnije i najviše razine antioksidativnih tvari, odnosno vitamina A - 0,465 mg L-1, E - 1,302 mg L-1 i D3 - 0,653 µg L-1 (P≤0,05), kao i β-laktoglobulin (3,28 g L-1, P≤0,01). Osim toga, kravlje mlijeko simentalca također odlikuje visokim sadržajem antimikrobnih proteina - laktoferina i lizozima (odnosno: 121,23 mg L-1, P≤0,01 i 9,66 µg L-1, P≤0,05) u usporedbi s drugim pasminama krava