The rising incidence of type 1 diabetes in south-eastern Poland. A study of the 0-29 year-old age group, 1980-1999

Wstęp: Badania przeprowadzone w ostatnich latach dostarczają informacji o wzroście zapadalności na cukrzycę typu 1 w różnych regionach świata, w tym także w krajach sąsiadujących z Polską. Celem badania było określenie długoterminowych trendów zapadalności na cukrzycę typu 1 w latach 1980-1999 i porównanie zapadalności między dwoma dekadami tego okresu, przyjmując 1989 rok za początek ekonomicznej i politycznej transformacji w Polsce. Materiał i metody: Rejestr zapadalności na cukrzycę typu 1 prowadzono zgodnie z rekomendacjami DERI, używając 3 źródeł danych o chorych. Wyliczono standaryzowaną zapadalność w 5-letnich przedziałach wiekowych oraz określono długoterminowy trend zapadalności na cukrzycę typu 1 w południowo-wschodniej Polsce. Wyniki: Wykazano znamienny trend wzrostowy w populacji od 0 do 29. roku życia zamieszkującej byłe województwo rzeszowskie w latach 1980-1999. Średnia zapadalność standaryzowana według wieku wynosiła 6,1/100 000 oraz istniała statystycznie znamienna różnica zapadalności pomiędzy dekadą lat 80. i 90., odpowiednio 5,3 (95% CI 4,5-6,0) i 6,8 (95% CI 5,9-7,6). Zapadalność była statystycznie znamiennie wyższa u mężczyzn w porównaniu do kobiet i wynosiła odpowiednio 6,7 i 5,5/100 000. Zapadalność była wyższa w grupie od 0 do 14. roku życia w porównaniu z grupą osób w wieku 15-29 lat, odpowiednio 6,4 i wobec 5,8/100 000. Najwyższą zapadalność zarejestrowano u chłopców w wieku 10-14 lat - 11,5/100 000, ponadto stwierdzono znamiennie rosnący trend zapadalności u dzieci w wieku 0-4 lat. Wnioski: Podsumowując, można stwierdzić, że zapadalność na cukrzycę typu 1 w badanej populacji była niska. Niemniej wykazano rosnący trend zapadalności w czasie 20-letniej obserwacji. Zapadalność w dekadzie lat 90. zarówno ogólna, jak i wśród mężczyzn była znamiennie wyższa w porównaniu do dekady lat 80.Introduction: Studies carried out over the last few years have provided information about the increase in the incidence of type 1 diabetes in different parts of the world including the European countries bordering Poland. The aim of study: The aim of this study was to determine the long-term trends in the incidence of type 1 diabetes over the 20 years between 1980 and 1999 and to compare the incidence during the decades preceding and following the 1989 economic and political transformation in Poland. Material and methods: The registration of type 1 diabetes among people aged 0-29 was drawn up according to the DERI recommendations using three data sources. We calculated the age-standardised incidence rates for five-year age groups and determined the long-term trend in the incidence of type 1 diabetes in south-eastern Poland. Results: A significant growth in the incidence of type 1 diabetes was observed among people aged 0-29 in the Rzeszów Province in the period between 1980 and 1999. The mean age-standardised incidence rate was 6.1/100 000, and a statistically significant difference was noted between the 1980s and the 1990s (5.3 [95%CI 4.5-6.0] and 6.8 [95%CI 5.9-7.6]). The male incidence of 6.7 significantly exceeded that for females - 5.5/100 000. There was also a higher in-cidence in the group aged 0-14 in comparison with the group aged 15-29 (6.4 and 5.8/100 000 respectively). The highest incidence was found in boys aged 10-14 (11.5/100 000) and a significantly rising trend was observed in children of 0-4 years old. Conclusions: The mean incidence of type 1 diabetes among the study population was low. Nevertheless, we demonstrated a significantly increasing trend in the incidence during the 20-year observation period. The incidence in the 1990s, both in general and for males, was significantly higher when compared to the 1980s

Two cases of serious hepatic injury caused by antithyroid drugs

W pracy przedstawiono dwa przypadki istotnego uszkodzenia wątroby spowodowanego przez tyreostatyki u kobiet z chorobą Gravesa- Basedowa leczonych z powodu nietolerancji kolejno metimazolem i propylotiouracylem. Dominującym objawem była żółtaczka trwająca ogółem około 3 miesięcy. W leczeniu poza odstawieniem tyreostatyków stosowano prednison oraz kwas ursodezoksycholowy. Pozytywny wpływ na przebieg choroby miała także likwidacja tyreotoksykozy po podaniu 131I. W podsumowaniu podkreślono znaczenie szybkiego odstawienia tyreostatyku w momencie wystąpienia istotnych objawów toksycznych oraz zaniechanie próby zamiany tyreostatyku na inny na rzecz leczenia radiojodem.We present two cases of severe hepatotoxicity caused by antithyroid drugs in women with Graves disease. The first medication in both cases was methimazole replaced by propylhiouracil due to intolerance. The main symptom was jaundice lasting about 2 months. As a first step in the treatment we terminated the antithyroid drug administration and introduced prednisone and ursodesoksycholic acid therapy. The termination of thyrotoxicosis by means of 131 I administration had also positive influence on the course of disease. In summary we emphasise the significance of prompt discontinuation of antithyroid drug once toxic symptoms appeared and avoid replacement one thyrostatic drug for another in fovour of radioiodine treatment

Nonthyroidal illness syndrome as independent predictor of hospital mortality in the elderly hospitalized patients with COVID-19 pneumonia – single-center observation

Introduction and aim. Elderly patients with COVID-19 are at increased risk for adverse outcomes. This study aims to evaluate the prevalence of nonthyroidal illness syndrome (NTIS) in hospitalized patients with COVID-19 pneumonia, its independent impact on patients’ survival. Furthermore, to investigate selected inflammatory biomarkers in those patients and to determine whether they predict mortality associated with the disease. Material and methods. In this single-centered, retrospective study, the medical records of 53 patients with confirmed SARSCoV-2 infection who attended the provincial hospital between October 2020 and January 2021 were reviewed. Demographic data, laboratory values, comorbidities, treatments, and clinical outcomes were collected. We compared the data in survivor and non-survivor groups. Results. Of 393 adult patients with SARS-CoV-2 pneumonia, 53 (13,49%) met the inclusion criteria and were included. The median age was 72±12.2 years, 26 patients (49%) were men. The NTIS prevalence was 62.3% and showed a strong independent correlation with disease severity and mortality in COVID-19 patients (p=0.01). The interleukin-6, white blood cells, ferritin and neutrophil ratios also differed significantly statistically between survivors and non-survivors. Conclusion. NTIS and the lowering level of FT3 pose an independent prognostic marker of clinical deterioration and higher mortality in elderly patients with COVID-19

Assessment of real-world usage of lanreotide AUTOGEL 120 in Polish acromegalic patients - results from

Aim of the study: To assess resource utilization and costs of treatment with lanreotide AUTOGEL 120 mg (ATG120) administered as part of routine acromegaly care in Poland. Material and methods: A multicentre, non-interventional, observational study on resource utilization in Polish acromegalic patients treated with ATG120 at 4 weeks or extended (> 4 weeks) dosing interval. The study recruited adult acromegalic patients treated medically for ≥ 1 year including at least 3 injections of ATG120. Data on dosing interval, aspects of administration, and resource utilization were collected prospectively during 12 months. Costs were calculated in PLN from the public health-care payer perspective for the year 2013. Results: 139 patients were included in the analysis. Changes in dosing regimen were reported in 14 (9.4%) patients. Combined treatment was used in 11 (8%) patients. Seventy patients (50%) received ATG120 at an extended dosing interval; the mean number of days between injections was 35.56 (SD 8.4). ATG120 was predominantly administered in an out-patient setting (77%), by health-care professionals (94%). Mean time needed for preparation and administration was 4.33 and 1.58 min, respectively, mean product wastage - 0.13 mg. Patients were predominantly treated in an out-patient setting with 7.06 physician visits/patient/ year. The most common control examinations were magnetic resonance imaging of brain and brain stem (1.36/ patient/year), ultrasound of the neck (1.35/patient/year), GH (1.69/pa tient/ year), glycaemia (1.12/patient/year), IGF-1 (0.84/patient/year), pituitary-thyroid axis hormone levels assessment (TSH-0.58/patient/year, T4-0.78/patient/ year). There were 0.43 hospitalizations/ patient/year. For direct medical costs estimated at PLN 50 692/pa tient/ year the main item was the costs of ATG120 (PLN 4103.87/patient/month; 97%). The mean medical cost, excluding pharmacotherapy, was PLN 1445/patient/year (out-patient care - 49%, hospitalization - 23%, diagnostics/laboratory tests - 28%). Conclusions: These results represent the current use of ATG120 in the population of Polish acromegalic patients in a realistic clinical setting. Findings that 50% of patients could be treated with dose intervals of longer than 28 days support the potential of ATG120 to reduce the treatment burden

Assessment of real-world usage of lanreotide AUTOGEL 120 in Polish acromegalic patients – results from the prospective 12-months phase of Lanro-Study

AIM OF THE STUDY: To assess resource utilization and costs of treatment with lanreotide AUTOGEL 120 mg (ATG120) administered as part of routine acromegaly care in Poland. MATERIAL AND METHODS: A multicentre, non-interventional, observational study on resource utilization in Polish acromegalic patients treated with ATG120 at 4 weeks or extended (> 4 weeks) dosing interval. The study recruited adult acromegalic patients treated medically for ≥ 1 year including at least 3 injections of ATG120. Data on dosing interval, aspects of administration, and resource utilization were collected prospectively during 12 months. Costs were calculated in PLN from the public health-care payer perspective for the year 2013. RESULTS: 139 patients were included in the analysis. Changes in dosing regimen were reported in 14 (9.4%) patients. Combined treatment was used in 11 (8%) patients. Seventy patients (50%) received ATG120 at an extended dosing interval; the mean number of days between injections was 35.56 (SD 8.4). ATG120 was predominantly administered in an out-patient setting (77%), by health-care professionals (94%). Mean time needed for preparation and administration was 4.33 and 1.58 min, respectively, mean product wastage – 0.13 mg. Patients were predominantly treated in an out-patient setting with 7.06 physician visits/patient/year. The most common control examinations were magnetic resonance imaging of brain and brain stem (1.36/patient/year), ultrasound of the neck (1.35/patient/year), GH (1.69/patient/year), glycaemia (1.12/patient/year), IGF-1 (0.84/patient/year), pituitary-thyroid axis hormone levels assessment (TSH-0.58/patient/year, T4-0.78/patient/year). There were 0.43 hospitalizations/patient/year. For direct medical costs estimated at PLN 50 692/patient/year the main item was the costs of ATG120 (PLN 4103.87/patient/month; 97%). The mean medical cost, excluding pharmacotherapy, was PLN 1445/patient/year (out-patient care – 49%, hospitalization – 23%, diagnostics/laboratory tests – 28%). CONCLUSIONS: These results represent the current use of ATG120 in the population of Polish acromegalic patients in a realistic clinical setting. Findings that 50% of patients could be treated with dose intervals of longer than 28 days support the potential of ATG120 to reduce the treatment burden