Rola zarządzania kryzysowego w systemie zarządzania bezpieczeństwem narodowym

Crisis management has a great importance: in functioning of the state apparatuses for the peace, the balance, the stability and the safety of citizens. Counteraction to natural risks and those triggered by human activity belongs to tasks to the civil service and the state apparatus forces (Police, Border Guard, Fire Service, etc.). State, as an organization, should plan how to organize and react in the moment of danger appearance.Zarządzanie kryzysowe ma ogromne znaczenie dla: funkcjonowania aparatów państwowych, dla pokoju, równowagi, stabilności i bezpieczeństwa obywateli. Przeciwdziałanie zagrożeniom naturalnym i wynikającym z działalności człowieka należy do zadań służby cywilnej i sił aparatu państwowego (Policja, Straż Graniczna, Straż Pożarna, itd.). Państwo, jako organizacja, powinno planować, organizować i reagować w momencie pojawienia się niebezpieczeństwa

Znaczenie dermoskopii w chorobie Grovera. Korelacja dermoskopowo-histologiczna

Abstact: Grover’s disease (transient acantholytic dermatosis) is characterized by the eruption of pruritic papules and papulovesicular lesions, mainly on the trunk and proximal extremities. The etiology of the disease remains unknown, however some drug-induced cases were reported. The diagnosis of Grover’s disease is based on histopathological examination which usually shows the presence of focal suprabasal acantholysis with dyskeratosis within the epidermis. There are four main histopathological patterns of this disease, including the Darier-like pattern, the Hailey-Hailey-like pattern, pemphigus-like pattern and eczema-like pattern. The main purpose of the study was to describe clinical, dermoscopic and histopathological features of skin lesions in three patients with three different patterns of Grover’s disease. The study was carried out on three patients with observable characteristic dermoscopic features of skin lesions who had been diagnosed with Grover’s disease based on the histopathological examination. In dermoscopy of the first one, yellow-brown polygonal structures with a white “halo” corresponding to focal acantholysis with dyskeratosis and hyperkeratosis were observed. Some areas with enlarged and dilated blood vessels were also seen, as well as regular oval white structures with yellow centres, which might correspond to empty hair follicles with abnormal keratosis in their ostia. In dermoscopy of the second patient, polygonal brown structures with scales corresponding to focal acantholysis with desquamation and dilated irregular blood vessels were observed. In dermoscopy of the third one, yellow-brown polygonal structures covered with scale and haemorrhagic crusts were observed. Dermoscopy is a useful diagnostic tool in patients suspected for Grover’s disease and gives characteristic dermoscopic features of yellow-brown polygonal structures corresponding to irregular acantholysis and disturb keratinization in histopathology. Streszczenie: Choroba Grovera (przemijająca dermatoza z akantolizą) charakteryzuje się obecnością rozsianych swędzących grudek lub zmian pęcherzykowo-grudkowych głównie na tułowiu i proksymalnych częściach kończyn. Etiologia choroby pozostaje nieznana, ale opisywano przypadki indukowane różnymi lekami. Rozpoznanie choroby Grovera opiera się na badaniu histopatologicznym, które wykazuje obecność ogniskowej nieregularnej akantolizy ponad warstwą podstawną naskórka z towarzysząca dyskeratozą lub zaburzonym rogowaceniem keratynocytów powyżej. Wyróżnia się cztery główne wzory histopatologiczne tej choroby: obraz podobny do choroby Dariera, do choroby Hailey-Hailey, do pęcherzycy i obraz wypryskopodobny. Celem badania było opisanie klinicznych, dermoskopowych i histopatologicznych cech zmian skórnych u trzech pacjentów z trzema różnymi odmianami choroby Grovera. Badanie dermoskopowe zmian skórnych przeprowadzono u trzech pacjentów z rozpoznaniem histologicznym choroby Grovera, w celu określenia najbardziej charakterystycznych cech dermoskopowych tej choroby. W badaniu dermoskopowym pierwszego pacjenta stwierdzono obecność żółto-brązowych wielokątnych struktur z białawą obwódką odpowiadających ogniskowej akantolizie z dyskeratozą i hiperkeratozą. Widoczne były również obszary z powiększonymi i poszerzonymi naczyniami krwionośnymi, a także regularne owalne białe struktury z żółtymi środkami, które mogły odpowiadać pustym mieszkom włosowym z nieprawidłowym rogowaceniem w ich lejkach. U drugiego pacjenta dermoskopowo stwierdzono obecność wielokątnych brązowych struktur pokrytych łuską odpowiadających ogniskowej akantolizie z nieprawidłowym rogowaceniem na powierzchni, oraz poszerzone nieregularnie naczynia krwionośne. U trzeciego pacjenta w dermoskopii stwierdzono żółto-brązowe wielokątne struktury pokryte łuską i krwotocznymi strupami. Dermoskopia jest użytecznym narzędziem diagnostycznym u pacjentów podejrzanych o chorobę Grovera i obrazuje charakterystyczne żółto-brązowe, wielokątne struktury odpowiadające nieregularnej akantolizie z nieprawidłowym rogowaceniem w badaniu histopatologicznym.Abstact: Grover’s disease (transient acantholytic dermatosis) is characterized by the eruption of pruritic papules and papulovesicular lesions, mainly on the trunk and proximal extremities. The etiology of the disease remains unknown, however some drug-induced cases were reported. The diagnosis of Grover’s disease is based on histopathological examination which usually shows the presence of focal suprabasal acantholysis with dyskeratosis within the epidermis. There are four main histopathological patterns of this disease, including the Darier-like pattern, the Hailey-Hailey-like pattern, pemphigus-like pattern and eczema-like pattern. The main purpose of the study was to describe clinical, dermoscopic and histopathological features of skin lesions in three patients with three different patterns of Grover’s disease. The study was carried out on three patients with observable characteristic dermoscopic features of skin lesions who had been diagnosed with Grover’s disease based on the histopathological examination. In dermoscopy of the first one, yellow-brown polygonal structures with a white “halo” corresponding to focal acantholysis with dyskeratosis and hyperkeratosis were observed. Some areas with enlarged and dilated blood vessels were also seen, as well as regular oval white structures with yellow centres, which might correspond to empty hair follicles with abnormal keratosis in their ostia. In dermoscopy of the second patient, polygonal brown structures with scales corresponding to focal acantholysis with desquamation and dilated irregular blood vessels were observed. In dermoscopy of the third one, yellow-brown polygonal structures covered with scale and haemorrhagic crusts were observed. Dermoscopy is a useful diagnostic tool in patients suspected for Grover’s disease and gives characteristic dermoscopic features of yellow-brown polygonal structures corresponding to irregular acantholysis and disturb keratinization in histopathology. Streszczenie: Choroba Grovera (przemijająca dermatoza z akantolizą) charakteryzuje się obecnością rozsianych swędzących grudek lub zmian pęcherzykowo-grudkowych głównie na tułowiu i proksymalnych częściach kończyn. Etiologia choroby pozostaje nieznana, ale opisywano przypadki indukowane różnymi lekami. Rozpoznanie choroby Grovera opiera się na badaniu histopatologicznym, które wykazuje obecność ogniskowej nieregularnej akantolizy ponad warstwą podstawną naskórka z towarzysząca dyskeratozą lub zaburzonym rogowaceniem keratynocytów powyżej. Wyróżnia się cztery główne wzory histopatologiczne tej choroby: obraz podobny do choroby Dariera, do choroby Hailey-Hailey, do pęcherzycy i obraz wypryskopodobny. Celem badania było opisanie klinicznych, dermoskopowych i histopatologicznych cech zmian skórnych u trzech pacjentów z trzema różnymi odmianami choroby Grovera. Badanie dermoskopowe zmian skórnych przeprowadzono u trzech pacjentów z rozpoznaniem histologicznym choroby Grovera, w celu określenia najbardziej charakterystycznych cech dermoskopowych tej choroby. W badaniu dermoskopowym pierwszego pacjenta stwierdzono obecność żółto-brązowych wielokątnych struktur z białawą obwódką odpowiadających ogniskowej akantolizie z dyskeratozą i hiperkeratozą. Widoczne były również obszary z powiększonymi i poszerzonymi naczyniami krwionośnymi, a także regularne owalne białe struktury z żółtymi środkami, które mogły odpowiadać pustym mieszkom włosowym z nieprawidłowym rogowaceniem w ich lejkach. U drugiego pacjenta dermoskopowo stwierdzono obecność wielokątnych brązowych struktur pokrytych łuską odpowiadających ogniskowej akantolizie z nieprawidłowym rogowaceniem na powierzchni, oraz poszerzone nieregularnie naczynia krwionośne. U trzeciego pacjenta w dermoskopii stwierdzono żółto-brązowe wielokątne struktury pokryte łuską i krwotocznymi strupami. Dermoskopia jest użytecznym narzędziem diagnostycznym u pacjentów podejrzanych o chorobę Grovera i obrazuje charakterystyczne żółto-brązowe, wielokątne struktury odpowiadające nieregularnej akantolizie z nieprawidłowym rogowaceniem w badaniu histopatologicznym

Bull’s head sign in the scintigraphy of a young female with recurrent chest pain

In this case we report a 38-year-old female patient with history of recurrent retrosternal chest pain lasting almost 5 years. Standard X-rays of chest and spine revealed no abnormalities. In a physical examination tenderness of anterior chest wall was observed, especially in sternoclavicular areas. SAPHO (synovitis, acne, pustulosis, hyperostosis, osteitis) syndrome was taken into consideration despite of lack of typical skin lesions (acne, pustulosis). We decided to implement 99mTc scintigraphy. Increased osteoblastic activity (intense 99-technetium intake) in manubriosternal and both sternoclavicular regions represents bull’s head sign which is a rare finding, but pathognomonic to SAPHO syndrome. After a 3-month therapy with aceclofenac 100 mg, total remission was reached. If we rule out this rare condition like SAPHO based on lack of abnormalities in X-rays, the reason of symptoms could be still unrecognized. 99mTc scintigraphy is valuable to show even subclinical areas of involvement and to monitor treatment response in SAPHO syndrome

Periostin in exhaled breath condensate and in serum of asthmatic patients : relationship to upper and lower airway disease

PURPOSE: Periostin is considered a biomarker for eosinophilic airway inflammation and have been associated with NSAID-Exacerbated Respiratory Disease (NERD) and chronic rhinosinusitis (CRS). In this study, we aimed to evaluate periostin in exhaled breath condensate (EBC) and in serum of patients with various asthma phenotypes. METHODS: The study included 40 asthmatic patients (22 with NERD) and 17 healthy controls. All the procedures (questionnaire, spirometry, FeNO, nasal swabs, EBC collecting, and blood sampling) were performed on the same day. Periostin concentrations were measured using an ELISA kit. RESULTS: Periostin was detected in EBC from 37 of 40 asthmatics and in 16 from 17 of controls. The concentration of periostin in EBC did not differ between the study groups and was not associated with NERD or asthma severity. However, the EBC periostin was significantly higher in asthmatics with CRS as compared to those without (3.1 vs 2 ng/mL, P=0.046). Patients with positive bacterial culture from nasal swabs had higher EBC periostin concentrations than those without (3.2 vs 2.1 ng/mL; P=0.046). The mean serum periostin level was higher in asthmatics with a 1-year history of exacerbation than in those without (3.2 vs 2.3 ng/mL, P=0.045). Asthmatics with skin manifestation of NSAIDs hypersensitivity had higher serum periostin levels as compared to those without (3.5 vs 2.3 ng/mL; P=0.03). CONCLUSIONS: EBC periostin levels seem to reflect intensity of upper airway disease in asthmatics, while serum levels of periostin are associated with asthma activity (exacerbations or FeNO) or NERD subphenotypes

Machine Learning Successfully Detects Patients with COVID-19 Prior to PCR Results and Predicts Their Survival Based on Standard Laboratory Parameters in an Observational Study

Introduction: In the current COVID-19 pandemic, clinicians require a manageable set of decisive parameters that can be used to (i) rapidly identify SARS-CoV-2 positive patients, (ii) identify patients with a high risk of a fatal outcome on hospital admission, and (iii) recognize longitudinal warning signs of a possible fatal outcome. Methods: This comparative study was performed in 515 patients in the Maria Skłodowska-Curie Specialty Voivodeship Hospital in Zgierz, Poland. The study groups comprised 314 patients with COVID-like symptoms who tested negative and 201 patients who tested positive for SARS-CoV-2 infection; of the latter, 72 patients with COVID-19 died and 129 were released from hospital. Data on which we trained several machine learning (ML) models included clinical findings on admission and during hospitalization, symptoms, epidemiological risk, and reported comorbidities and medications. Results: We identified a set of eight on-admission parameters: white blood cells, antibody-synthesizing lymphocytes, ratios of basophils/lymphocytes, platelets/neutrophils, and monocytes/lymphocytes, procalcitonin, creatinine, and C-reactive protein. The medical decision tree built using these parameters differentiated between SARS-CoV-2 positive and negative patients with up to 90–100% accuracy. Patients with COVID-19 who on hospital admission were older, had higher procalcitonin, C-reactive protein, and troponin I levels together with lower hemoglobin and platelets/neutrophils ratio were found to be at highest risk of death from COVID-19. Furthermore, we identified longitudinal patterns in C-reactive protein, white blood cells, and D dimer that predicted the disease outcome. Conclusions: Our study provides sets of easily obtainable parameters that allow one to assess the status of a patient with SARS-CoV-2 infection, and the risk of a fatal disease outcome on hospital admission and during the course of the disease

Synthesis and Investigation of Anti-tumor Properties of Novel, Bicyclic Furopyrimidine, Pyrrolopyrimidine and Pyrimidopyridazine Nucleoside Analogues

A series of nine hitherto unknown bicylic pyrimidine nucleoside analogues (BCNAs) bearing bicyclic furo[2,3-d]pyrimidin-2(3H)-one, 3H-pyrrolo[2,3-d]pyrimidin-2(7H)-one and 5,6-dihydropyrimido[4,5-c]pyridazin-7(8H)-one bases were prepared in a straightforward approach. The synthesised compounds posses β-D-rybofuranose or β-D-2-deoxyrybofuranose or β-D-arabinofuranose moieties attached to each of the heterocylic ring systems. This is one of a few examples of synthesis of pyrrolo[2,3-d]pyrimidin-2(7H)-one and dihydropyrimido[4,5-c]pyridazin-7(8H)-one nucleosides, and the first example of such nucleosides possessing arabinose moiety. A key synthetic step was a Sonogashira coupling reaction. For coupling with 4-phenyl-1-butyne, we used deprotected 5-iodouridine, 2’-deoxy-5-iodouridine, and 5-iodoarabinouridine and this reaction was followed by cycloisomerization and subsequent conversion of the furane ring into a pyrole ring or a pyridiazine. This approach resulted in the creation of small library of compounds, which were evaluated for their antiproliferative properties against HL-60 and Jurkat E6.1 cell lines. Of all tested compounds, only 3-(β-D-rybofuranosyl)-6-(2-phenylethyl)furo[2,3-d]pyrimidin-2(3H)-one exhibited weak anti-proliferative activity, with IC50 values of 54 and 81 µM for HL-60 and Jurkat E6.1 cells, respectively

Molecular characterization of the PhiKo endolysin from Thermus thermophilus HB27 bacteriophage phiKo and its cryptic lytic peptide RAP-29

IntroductionIn the era of increasing bacterial resistance to antibiotics, new bactericidal substances are sought, and lysins derived from extremophilic organisms have the undoubted advantage of being stable under harsh environmental conditions. The PhiKo endolysin is derived from the phiKo bacteriophage infecting Gram-negative extremophilic bacterium Thermus thermophilus HB27. This enzyme shows similarity to two previously investigated thermostable type-2 amidases, the Ts2631 and Ph2119 from Thermus scotoductus bacteriophages, that revealed high lytic activity not only against thermophiles but also against Gram-negative mesophilic bacteria. Therefore, antibacterial potential of the PhiKo endolysin was investigated in the study presented here.MethodsEnzyme activity was assessed using turbidity reduction assays (TRAs) and antibacterial tests. Differential scanning calorimetry was applied to evaluate protein stability. The Collection of Anti-Microbial Peptides (CAMP) and Antimicrobial Peptide Calculator and Predictor (APD3) were used to predict regions with antimicrobial potential in the PhiKo primary sequence. The minimum inhibitory concentration (MIC) of the RAP-29 synthetic peptide was determined against Gram-positive and Gram-negative selected strains, and mechanism of action was investigated with use of membrane potential sensitive fluorescent dye 3,3′-Dipropylthiacarbocyanine iodide (DiSC3(5)).Results and discussionThe PhiKo endolysin is highly thermostable with melting temperature of 91.70°C. However, despite its lytic effect against such extremophiles as: T. thermophilus, Thermus flavus, Thermus parvatiensis, Thermus scotoductus, and Deinococcus radiodurans, PhiKo showed moderate antibacterial activity against mesophiles. Consequently, its protein sequence was searched for regions with potential antibacterial activity. A highly positively charged region was identified and synthetized (PhiKo105-133). The novel RAP-29 peptide lysed mesophilic strains of staphylococci and Gram-negative bacteria, reducing the number of cells by 3.7–7.1 log units and reaching the minimum inhibitory concentration values in the range of 2–31 μM. This peptide is unstructured in an aqueous solution but forms an α-helix in the presence of detergents. Moreover, it binds lipoteichoic acid and lipopolysaccharide, and causes depolarization of bacterial membranes. The RAP-29 peptide is a promising candidate for combating bacterial pathogens. The existence of this cryptic peptide testifies to a much wider panel of antimicrobial peptides than thought previously