Stewart Moore, Jewish Ethnic Identity and Relations in Hellenistic Egypt. With Walls of Iron?, Supplements to the Journal for the Study of Judaism 171, Brill: Leiden-Boston 2015, ss. 291

Artykuł recenzyjn

Biochemical and hematological changes following the 120-km open-water marathon swim

Data on physiological effects and potential risks of a ultraendurance swimming are scarce. This report presents the unique case of a 61-year old athlete who completed a non-stop open-water 120-km ultramarathon swim on the Warta River, Poland. Pre-swimming examinations revealed favorable conditions (blood pressure, 110/70 mmHg; rest heart rate, 54 beats/minute, ejection fraction, 60%, 20.2 metabolic equivalents in a maximal exercise test). The swimming time and distance covered were 27 h 33 min and 120 km, respectively. Blood samples for hematological and biochemical parameters were collected 30 min, 4 hrs, 10 hrs and 8 days after the swim. The body temperature of the swimmer was 36.7°C before and 35.1°C after the swim. The hematological parameters remained within the reference range in the postexercise period except for leucocytes (17.5 and 10.6 x G/l noted 30 minutes and 4 hours after the swim, respectively). Serum urea, aspartate aminotransferase and C-reactive protein increased above the reference range reaching 11.3 mmol/l, 1054 nmol/l/s and 25.9 mg/l, respectively. Symptomatic hyponatremia was not observed. Although the results demonstrate that an experienced athlete is able to complete an ultra-marathon swim without negative health consequences, further studies addressing the potential risks of marathon swimming are required.

Blood pressure and cholesterol control in patients with hypertension and hypercholesterolemia : the results from the Polish multicenter national health survey WOBASZ II

Introduction: Persons with multiple risk factors of cardiovascular disease (CVD) are at a greater risk than persons exposed to a single risk factor. Control of specific risk factors of CVD in Poland is rather poor. Effective control of comorbid hypertension and hypercholesterolemia seems especially challenging. Objectives: The aim of the study was to assess the control of hypertension and hypercholesterolemia in patients with both hypertension and hypercholesterolemia; data from the Polish multicenter national health survey, WOBASZ II, were analyzed. Patients and methods: The WOBASZ II study was a cross-sectional survey conducted from 2013 to 2014 in 6170 people (3410 women and 2760 men) from all 16 Polish voivodships. Results: Age-standardized prevalence of coexisting hypertension and hypercholesterolemia in WOBASZ II sample was 34.6%. The prevalence of hypercholesterolemia in participants with hypertension was 69.7%. Age-standardized rates of control of hypertension, hypercholesterolemia, and both hypertension and hypercholesterolemia in the entire analyzed age range of 19 to 99 years was 24.3%, 11.2%, and 5.4%, respectively. In multivariable logistic regression models, control of both hypertension and hypercholesterolemia was associated with smoking (odds ratio [OR], 0.5; 95% CI, 0.34–0.76), cardiovascular disease (OR, 2.25; 95% CI, 1.70–2.97), frequent medical visits (OR, 1.76; 95% CI, 1.33–2.32), and high education level (OR, 1.37; 95% CI, 1.03–1.80). Conclusions: Comorbid hypertension and hypercholesterolemia were observed in one-third of the Polish population (included in WOBASZ II study). Only 5.4% have both risk factors controlled. After adjustment for covariates, female sex, nonsmoking, comorbid CVD or diabetes, the frequency of medical visits, and high level of education appeared to increase the proportion of controlled hypertension or hypercholesterolemia

The dmc1 Mutant Allows an Insight Into the DNA Double-Strand Break Repair During Meiosis in Barley (Hordeum vulgare L.)

Meiosis is a process of essential importance for sexual reproduction, as it leads to production of gametes. The recombination event (crossing-over) generates genetic variation by introducing new combination of alleles. The first step of crossing-over is introduction of a targeted double-strand break (DSB) in DNA. DMC1 (Disrupted Meiotic cDNA1) is a recombinase that is specific only for cells undergoing meiosis and takes part in repair of such DSBs by searching and invading homologous sequences that are subsequently used as a template for the repair process. Although role of the DMC1 gene has been validated in Arabidopsis thaliana, a functional analysis of its homolog in barley, a crop species of significant importance in agriculture, has never been performed. Here, we describe the identification of barley mutants carrying substitutions in the HvDMC1 gene. We performed mutational screening using TILLING (Targeting Induced Local Lesions IN Genomes) strategy and the barley TILLING population, HorTILLUS, developed after double-treatment of spring barley cultivar ‘Sebastian’ with sodium azide and N-methyl-N-nitrosourea. One of the identified alleles, dmc1.c, was found independently in two different M2 plants. The G2571A mutation identified in this allele leads to a substitution of the highly conserved amino acid (arginine-183 to lysine) in the DMC1 protein sequence. Two mutant lines carrying the same dmc1.c allele show similar disturbances during meiosis. The chromosomal aberrations included anaphase bridges and chromosome fragments in anaphase/telophase I and anaphase/telophase II, as well as micronuclei in tetrads. Moreover, atypical tetrads containing three or five cells were observed. A highly increased frequency of all chromosome aberrations during meiosis have been observed in the dmc1.c mutants compared to parental variety. The results indicated that DMC1 is required for the DSB repair, crossing-over and proper chromosome disjunction during meiosis in barley

Methotrexate: Safe and effective

Rheumatoid arthritis (RA) is the most common systemic connective tissue disease. The prevalence of RA in the general population is 0.3–1.5% (in Europe 0.8% in the adult population), with women affected 3 times more often. The first clinical description of the disease was made in 1859 by Garrod. More than 100 years later, methotrexate was used for the first time in RA therapy (in 1951). To this day, it is the primary drug in the therapy of this disease, as well as many other autoimmune and cancer diseases. The article presents the most important information on the use of methotrexate and the results of a study conducted at the local Center, confirming the safety of using the drug

Rozpowszechnienie palenia tytoniu oraz palenie bierne w populacyjnych badaniach polskiego programu cindi w latach 1991–2007 – analiza porównawcza

Prevalence of tobacco use and environmental tobacco smoke in polish population research. WHO-CINDI Programme in 1991–2007This article is a report from comparison surveys, carried out in connection with WHO-CINDI Programme during the years 1991–2007. The analysis was based on random sampling tests concerning big Polish cities’ inhabitants, all in all almost 11.5 thousand respondents. Taking everything into consideration, it has been established, that:1. Regular smoking frequency becomes smaller (the effect of implemented prophylactic programmes, a so-called ‘intervention variable’).2. Still, propagation of environmental smoking is an alarming   phenomenon, however it is definitely improving. Despite the fact, that more and more respondents are living in a free-smoking zone, each 5-6 adult city inhabitant spends over 5 hours a day in a room full of smoke.3. Within time passing, as a result of quitting an addiction, a belief concerning harmful smoking consequences grows. This tendency is not yet sufficiently justified. Becoming alarmed with the concerning phenomenon is definitely not enough when making an opinion in this matter

Socioeconomic status and cardiovascular risk SCORE

  Background: Cardiovascular diseases (CVD) are one of the most frequent causes of morbidity and death both in men and women. The influence of the following factors on the occurrence and progression of atherosclerosis is well known: hyperten­sion, hypercholesterolaemia, tobacco smoking, obesity, diabetes, age, and sex. As well as the typical risk factors of CVD, there is also a significant association between the incidence of those diseases and socioeconomic status (SES). Aim: The aim of this study was to establish the correlation between SES status and CVD risk assessed according to the SCORE algorithm. Methods: The study encompassed 516 participants (207 men and 309 women) aged 40–74 years, who had never been diagnosed with any CVD. The SES was calculated by multiplying the patient’s education and net monthly income. The cor­relation between the SES and SCORE was established using linear and logistic regression analysis. Results: After considering the influence of age, an inverse correlation between the SCORE risk value and the SES index was established, both in the entire group (p = 0.006) and in the men’s group (p = 0.007). In the analysis of individual age subgroups, this correlation was demonstrated in the following groups: 55–59-year-olds (p = 0.011), 60–64-year-olds (p = 0.014), and 65–69-year olds (p = 0.034). A similar relationship was established in men aged 65–69 years (p = 0.038) and women aged 40–44 years (p = 0.003). The logistic regression analysis demonstrated that, after considering the influence of age, the odds of the SCORE risk value being ≥ 10% were becoming smaller along with the increase in the SES index value in the entire group (p = 0.048) and in the men’s group (p = 0.011). The odds ratio (OR) for the SCORE risk value being ≥ 10% depending on the SES index value was OR = 0.978 (95% confidence interval [CI] 0.956–0.999) in the entire group and OR = 0.964 (95% CI 0.938–0.992) in men. Furthermore, we also established that the risk of SCORE ≥ 5% decreased with the increase in the SES index value in the women’s group (OR = 0.970; 95% CI 0.941–0.999; p = 0.042). Conclusions: 1. We demonstrated a statistically significant correlation between the SES and the CVD risk assessed according to the SCORE algorithm. 2. The value of the CVD risk according to SCORE was inversely correlated with SES status.Wstęp: Schorzenia układu sercowo-naczyniowego są jedną z najczęstszych przyczyn zachorowań i umieralności zarówno wśród mężczyzn, jak i kobiet. Dotychczas określono wiele czynników ryzyka związanych z rozwojem schorzeń układu sercowo-naczyniowego. Dobrze znany jest wpływ czynników, takich jak: nadciśnienie tętnicze, hipercholesterolemia, palenie tytoniu, otyłość, cukrzyca, wiek oraz płeć na wystąpienie i progresję miażdżycy. Oprócz klasycznych czynników ryzyka schorzeń układu sercowo-naczyniowego istotny związek z występowaniem schorzeń z tej grupy ma pozycja socjoekonomiczna (SES). Cel: Celem pracy było określenie zależności między SES a ryzykiem sercowo-naczyniowym ocenionym wg algorytmu SCORE. Metody: Badanie jest częścią projektu WOBASZ II, które przeprowadzono w Polsce w latach 2013–2014 w ramach profilaktyki pierwotnej schorzeń układu sercowo-naczyniowego. Analizie poddano dane zebrane w losowej grupie mieszkańców województw: śląskiego, dolnośląskiego i opolskiego. W każdym z województw wylosowano do badania 6 gmin: 2 małe (do 8 tys. mieszkańców), 2 średnie (od 8 do 40 tys.) i 2 duże (od 40 tys.). Następnie w każdej gminie wylosowano 70 mężczyzn i 70 kobiet w wieku 20 i więcej lat. U wszystkich badanych określono pozycję socjoekonomiczną, którą zdefiniowano wg metody zastosowanej w badaniu ATTICA, jako iloczyn wykształcenia i dochodu miesięcznego (netto). Poszczególnym kategoriom zmiennych nadawano odpowiednie wartości liczbowe — wykształcenie: niepełne podstawowe = 1, podstawowe = 2, zasadnicze zawodowe po szkole podstawowej = 3, gimnazjum = 4, zasadnicze zawodowe po gimnazjum = 5, liceum/technikum (średnie) = 6, policealne = 7, licencjat (niepełne wyższe) = 8, wyższe = 9, dochód: ≤ 500 zł = 1, 501–1000 zł = 2, 1001–1500 zł = 3, 1501–2000 zł = 4, 2001–2500 zł = 5, 2501–3000 zł = 6 i > 3001 zł = 7. Iloczyn wykształcenia i dochodu stanowił wynik SES. Grupy SES zostały wyznaczone następująco: niski SES — wskaźnik 18. Wybrana losowo grupa liczyła 884 osoby. Z powyższej grupy wyodrębniono 516 osób (207 mężczyzn i 309 kobiet) w wieku 40–74 lat, u których nie stwierdzono schorzeń układu sercowo-naczyniowego. Określono u nich ryzyko sercowo-naczyniowe na podstawie algorytmu SCORE dla populacji Polski. SES oceniono jako iloczyn wykształcenia i dochodu miesięcznego (netto). Następnie określono związek między SES a SCORE przy użyciu analizy regresji liniowej i logistycznej. Wyniki: Wyniki analizy regresji liniowej wykazały, że po uwzględnieniu wpływu wieku zależność pomiędzy wartością ryzyka SCORE a wskaźnikiem SES została zaobserwowana zarówno w całej badanej grupie (p = 0,006), jak i w grupie mężczyzn (p = 0.007). Analizując poszczególne podgrupy wiekowe całej badanej grupy, zależność ta potwierdziła się w grupach wiekowych: 55–59 lat (p = 0,011), 60–64 lata (p = 0,014) i 65–69 lat (p = 0.034). Podobną zależność stwierdzono w grupie mężczyzn w wieku 65–69 lat (p = 0,038) i kobiet w wieku 40–44 lata (p = 0,003). Wyniki analizy regresji logistycznej wykazały, że po uwzględnieniu wpływu wieku zwiększone ryzyko wystąpienia wartości ryzyka SCORE ≥ 10% w zależności od wartości wskaźnika SES zaobserwowano w całej badanej grupie (p = 0,048) i w grupie mężczyzn (p = 0,011). Szansa wystąpienia wartości ryzyka SCORE ≥ 10% w zależności od wartości wskaźnika SES wyniosła OR = 0,978 (95% CI 0,956–0,999) w całej grupie oraz OR = 0,964 (95% CI 0,938–0,992) wśród mężczyzn. Ponadto stwierdzono zwiększone ryzyko wystąpienia SCORE ≥ 5% w zależności od wartości wskaźnika SES w grupie kobiet bez uwzględnienia wpływu wieku (p = 0,042; OR = 0,970; 95% CI 0,941–0,999). Wnioski: 1. Wykazano istotną statystycznie zależność między pozycją socjoekonomiczną a ryzykiem sercowo-naczyniowym ocenionym wg algorytmu SCORE. 2. Wartość ryzyka sercowo-naczyniowego wg SCORE była odwrotnie związana z pozycją społeczno-ekonomiczną

Exercise-Induced Arrhythmia or Munchausen Syndrome in a Marathon Runner?

A 36-year-old professional marathon runner reported sudden irregular palpitations occurring during competitions, with heart rates (HR) up to 230 bpm recorded on a sports HR monitor (HRM) over 4 years. These episodes subsided upon the cessation of exercise. Electrocardiograms, echocardiography, and cardiac magnetic resonance imaging results were borderline for athlete's heart. Because an electrophysiology study and standard exercise tests provoked no arrhythmia, doctors suspected Munchausen syndrome. Ultimately, an exercise test that simulated the physical effort of a competition provoked tachyarrhythmia consistent with the HRM readings. This case demonstrates the diagnostic difficulties related to exercise-induced arrhythmia and the diagnostic usefulness of sports HRMs

Amateur Athlete with Sinus Arrest and Severe Bradycardia Diagnosed through a Heart Rate Monitor: A Six-Year Observation—The Necessity of Shared Decision-Making in Heart Rhythm Therapy Management

Heart rate monitors (HRMs) are used by millions of athletes worldwide to monitor exercise intensity and heart rate (HR) during training. This case report presents a 34-year-old male amateur soccer player with severe bradycardia who accidentally identified numerous pauses of over 4 s (maximum length: 7.3 s) during sleep on his own HRM with a heart rate variability (HRV) function. Simultaneous HRM and Holter ECG recordings were performed in an outpatient clinic, finding consistent 6.3 s sinus arrests (SA) with bradycardia of 33 beats/min. During the patient's hospitalization for a transient ischemic attack, the longest pauses on the Holter ECG were recorded, and he was suggested to undergo pacemaker implantation. He then reduced the volume/intensity of exercise for 4 years. Afterward, he spent 2 years without any regular training due to depression. After these 6 years, another Holter ECG test was performed in our center, not confirming the aforementioned disturbances and showing a tendency to tachycardia. The significant SA was resolved after a period of detraining. The case indicates that considering invasive therapy was unreasonable, and patient-centered care and shared decision-making play a key role in cardiac pacing therapy. In addition, some sports HRM with an HRV function can help diagnose bradyarrhythmia, both in professional and amateur athletes. Keywords: athlete’s heart; block S-A; bradyarrhythmia; cardioneuroablation; deconditioning; heart rate monitors; heart rate variability; leisure time activity; pacing therapy; shared decision-making