The Role of Sirtuin 1 in the Regulation of Autophagy and Respiratory Syncytial Virus-induced Immune Responses

Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract disease in children, and a significant source of morbidity and mortality among those susceptible, including infants, the elderly, and those with chronic lung diseases. Severe RSV infection during infancy is highly correlated with asthmatic symptoms later in life, suggesting a chronic alteration of the pulmonary immune environment even after viral clearance. Within the airways, dendritic cells (DCs) drive innate and adaptive immune responses to pathogens through the production of proinflammatory cytokines and the activation of T cell responses. Autophagy, a pathway that sequesters intracellular material within double-walled vesicles for degradation by lysosomes, enhances Toll-like receptor-dependent activation, cytokine production, and antigen presenting cell function within RSV-infected DCs. Of interest, key proteins that orchestrate autophagosome formation are targeted by SIRT1, a NAD+-dependent histone and protein deacetylase. SIRT1 impacts many areas of biology and pathophysiology, including immune function. However, the role of SIRT1 in DC biology and its subsequent impact on adaptive immunity has not been elucidated. We have demonstrated that SIRT1 regulates DC activation and autophagy-mediated processes during RSV infection, and that the absence of SIRT1 activity alters the antiviral immune response through the regulation of innate cytokine production. Upon infection, SIRT1 inhibitor (EX-527)-treated DCs, Sirt1 siRNA-treated DCs, or DCs from conditional knockout (Sirt1f/f-CD11c-Cre+) mice failed to upregulate autophagy and cytokine production, but retained the capacity to present antigen to T cells. Additionally, RSV infection of Sirt1f/f-CD11c-Cre+ mice resulted in altered lung and lymph node cytokine responses, leading to exacerbated pathology. Overall, these studies highlight the essential role of SIRT1-mediated DC cytokine production in fine-tuning the antiviral adaptive immune response, and establish SIRT1 as a promising therapeutic target for the prevention of severe RSV-induced lung disease.PHDMolecular & Cellular Path PhDUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttps://deepblue.lib.umich.edu/bitstream/2027.42/137127/1/aniaowcz_1.pd

Neutrofilowe zapalenie grzbietów rąk

Neutrofilowe zapalenie grzbietów rąk (NDH) jest rzadką, zlokalizowaną odmianą zespołu Sweeta. W obu jednostkach chorobowych występują: gorączka, neutrofilia, leukocytoza, podwyższenie odczynu Bienackiego i poziomu białka C-reaktywnego oraz zmiany rumieniowo-naciekowe. W NDH dodatkowo mogą występować pęcherze krwotoczne i martwica, podobne jak w piodermii zgorzelinowej. Podobnie jak w zespole Sweeta NDH często wiąże się między innymi z nowotworami złośliwymi, chorobami zapalnymi jelit, nietolerancją leków, chorobami autoimmunologicznymi (reumatycznymi). W artykuleomówiono przypadek pacjenta z neutrofilowym zapaleniem grzbietów rąk związanym z chorobą rozrostową, zlokalizowanąw prawym płucu. Pacjent wykazał dobrą odpowiedź na leczenie ogólne kortykosteroidami i leczenie miejscowe

Public expenditure on healthcare in Poland (2010-2020)

Both expenditure on healthcare and the functioning of the entire healthcare system in Poland stir up considerable controversy and are often discussed in the media. Hospital debts, the low quality of services, and the low availability of specialist medical services form the basis for the discussion of the effectiveness of the healthcare system. Statistical data are also bleak. Total health expenditure in Poland in 2019 amounted to 6.3% of GDP (estimated expenditure), whereas the average for health expenditure in the OECD countries was 8.8%. Therefore, Poland is below the average, and is placed last but four in the ranking (stat.oecd.org). The aim of this article is the presentation of public expenditure on healthcare in Poland from 2010 to 2020. In order to achieve this, the following research methods were used: a critical analysis of the literature, an analysis of statistical data, and - to make the research more transparent and the research results clearer - a tabular method was used. Also, widely accepted measurements were used, such as absolute values in domestic and international currencies, values per capita, and values in relation to the Gross Domestic Product (GDP).oduct (GDP).Wydatki na ochronę zdrowia oraz funkcjonowanie całego systemu opieki zdrowotnej w Polsce budzą wiele kontrowersji i są częstym tematem poruszanym w mediach. Zadłużenie szpitali, niska jakość usług, niska dostępność świadczeń specjalistycznych stanowią podstawę dla dyskusji na temat wydajności systemu opieki zdrowotnej. Dane statystyczne też nie napawają optymizmem. Całkowite wydatki na zdrowie w Polsce w roku 2019 wyniosły 6,3% PKB(szacowane wydatki), podczas gdy średnia wydatków na zdrowie dla krajów OECD wyniosła 8,8 %.Polska jest zatem poniżej średniej, plasując się w tym rankingu na 5.miejscu od końca (stat.oecd.org). Celem artykułu jest przedstawienie wydatków publicznych ponoszonych na ochronę zdrowia w Polsce w latach 2010–2020. Dla realizacji celu wykorzystano następujące metody badawcze: krytyczną analizę literatury, analizę danych statystycznych, a dla zwiększenia przejrzystości oraz czytelności badań wykorzystano metodę tabelaryczną. Wykorzystano również ogólnie przyjęte mierniki, takie jak: wartości bezwzględne wyrażone w walucie krajowej i międzynarodowej, wartości per capita, wartości w relacji do produktu krajowego brutto (PKB)

E-prescription as a tool supporting the provision of services in health care entities

E-recepta, wprowadzona 25 maja 2018 r. w ramach pilotażu w dwóch miastach, początkowo spotkała się z wieloma barierami (nieufność i opór wobec nowych rozwiązań IT, niekompatybilność systemów gabinetowych z platformą P1, brak odpowiedniego sprzętu komputerowego w gabinetach, nieadekwatne łącza internetowe), obecnie jest jednym z najbardziej znanych i najczęściej wykorzystywanych e-narzędzi w usługach medycznych. Jej zastosowanie nabrało specjalnego znaczenia w czasie pandemii COVID-19, kiedy wymuszona izolacja utrudniała kontakty z personelem medycznym. Pacjenci, pozostawieni bez opieki medycznej, w bardzo ograniczonym zakresie mogli korzystać z usług ochrony zdrowia. Wówczas teleporady oraz cyfrowe recepty okazały się doskonałym remedium na tak problematyczną sytuację. Właściwie to pandemii COVID-19 zawdzięczamy rozwój wielu e-narzędzi oraz rozpowszechnienie ich zastosowania. Znaczenie e-recepty dla systemu i podmiotów świadczących usługi medyczne jest nie do przecenienia. Za jej pośrednictwem zarówno do systemu, jak i do wymienionych podmiotów trafia wiarygodna i dokładna informacja (np. o ilości przepisywanych leków, o stanie zdrowia polskich pacjentów czy wysokości kwot refundacji). E-recepta to nie tylko zapis, jaki lek powinien przyjąć pacjent, lecz również zbiór danych, które wykorzystane w odpowiedni sposób mogą stanowić drogowskaz dla dalszego rozwoju usług medycznych, programów profilaktycznych i kierunków zmian w systemie opieki zdrowotnej. Artykuł przedstawia informacje z zakresu wdrożenia i stosowania e-recepty przez personel medyczny w Polsce w latach 2018-2022. Informacje zawarte w opracowaniu mogą stanowić podstawę dla kolejnych opracowań w kraju i za granicą, dla międzynarodowych komparatywnych analiz, ze względu na ich aktualność i szczegółowość. Celem artykułu jest przedstawienie stopnia wykorzystania e-recepty przez personel medyczny w podmiotach ochrony zdrowia. Dla realizacji celu wykorzystano następujące metody badawcze: analiza krytyczna literatury przedmiotu i stron internetowych prezentujących rozwiązania cyfrowe dla systemu ochrony zdrowia, analiza materiałów źródłowych i danych liczbowych Centrum e-Zdrowia (CeZ).E-prescription, introduced on February 16, 2018, as part of a pilot program in two cities, initially met many barriers (resistance and doubts of medical staff, incompatibility of IT systems and inappropriate computer equipment or its lack in medical offices), and is currently one of the most well-known and the most frequently used e-tools in medical services. The usage of e-prescribing was crucial during the COVID-19 pandemic, when forced isolation made contacts with medical staff difficult or even impossible. Patients, left without medical care, could use health care services to a very limited extent. Then, teleconsultations and digital prescriptions turned out to be an excellent remedy for such a problematic situation. In fact, we owe the development of many e-tools and the spread of their use to the COVID-19 pandemic. The importance of e-prescription for the system and medical service providers cannot be overestimated. Through it, the system and health care entities receive reliable and accurate information (e.g. about the number of prescribed drugs, the health condition of Polish patients, or the amount of reimbursement). An e-prescription is not only a record of what medicine the patient should take, but a set of data that, when used in an appropriate manner, can constitute a guide for the further development of medical services, preventive programs and directions of changes in the health care system. The article presents information on the implementation and use of e-prescriptions by medical staff in Poland in 2018-2022. The information contained in the article may constitute the basis for subsequent studies in Poland and abroad, for international comparative analyses, due to their timeliness and detail. The aim of the article is to present the degree of use of e-prescriptions by medical staff in health care entities. To achieve the goal, the fol-lowing research methods were used: critical analysis of literature and websites presenting digital solutions for the health care system, analysis of source materials and numerical data from the e-Health Center (CeZ)

Social Policy Programme “The Family 500+” – Assumptions, Results, and Costs of Functioning: Is It Worth?

The unfavorable demographic situation and the falling number of births resulted in an increased interest among Polish politicians in introducing tools to social policy that would reverse this negative trend. Implemented to social policy by Prawo i Sprawiedliwość Party in 2016, the “Family 500+” benefit has become such a tool. According to the government’s intention, this financial aid for families with children aims to reverse the decline in the number of births observed for many years and reduce the scale of poverty among families with the most complex financial situation. After several years of the “Family 500+” Program in force, it is difficult to clearly define whether the goals were achieved and whether the expenses for financing the program were adequate to the results. The aim of the article is an attempt at the assessment of the functioning of the Family 500+ Programme. Both the statutory assumptions of the programme, the costs of its functioning, and its results so far were analyzed. The central part of the analysis covered the period 2016–2019

E-prescription as a tool supporting the provision of services in health care entities

E-prescription, introduced on February 16, 2018, as part of a pilot program in two cities, initially met many barriers (resistance and doubts of medical staff, incompatibility of IT systems and inappropriate computer equipment or its lack in medical offices), and is currently one of the most well-known and the most frequently used e-tools in medical services. The usage of e-prescribing was crucial during the COVID-19 pandemic, when forced isolation made contacts with medical staff difficult or even impossible. Patients, left without medical care, could use health care services to a very limited extent. Then, teleconsultations and digital prescriptions turned out to be an excellent remedy for such a problematic situation. In fact, we owe the development of many e-tools and the spread of their use to the COVID-19 pandemic. The importance of e-prescription for the system and medical service providers cannot be overestimated. Through it, the system and health care entities receive reliable and accurate information (e.g. about the number of prescribed drugs, the health condition of Polish patients, or the amount of reimbursement). An e-prescription is not only a record of what medicine the patient should take, but a set of data that, when used in an appropriate manner, can constitute a guide for the further development of medical services, preventive programs and directions of changes in the health care system. The article presents information on the implementation and use of e-prescriptions by medical staff in Poland in 2018-2022. The information contained in the article may constitute the basis for subsequent studies in Poland and abroad, for international comparative analyses, due to their timeliness and detail. The aim of the article is to present the degree of use of e-prescriptions by medical staff in health care entities. To achieve the goal, the fol-lowing research methods were used: critical analysis of literature and websites presenting digital solutions for the health care system, analysis of source materials and numerical data from the e-Health Center (CeZ)

E-SERVICES IN PUBLIC ADMINISTRATION ON THE BASIS OF THE POLISH SOCIAL INSURANCE INSTITUTION (ZUS)

The term e-services refers to such services that are delivered over the Internet and their rendition is frequently automated and remote. Apart from the Internet, an e-service may also be provided by means of mobile devices or television. The wider and wider range of e-services is offered by institutions from the public administration sector, striving to anticipate their client's expectations (especially those of the younger generation) and using the ongoing digitisation process. This study aims at presenting the role and opinions of e-service in one of the social insurance institutions, i.e. Social Insurance Institution (ZUS) where numerous electronic tools have been implemented facilitating work and enabling clients to make contact, get information, send and receive documents. All these efforts are made so as to increase accessibility for prospective and current clients as well as to make the institution's operations more efficient. To achieve this, the following research methods were used: a critical analysis of the literature, an analysis of statistical data, an analysis of survey results (conducted by ZUS), and a survey questionnaire (own research).Mianem e-usług określa się takie usługi, których świadczenie odbywa się za pośrednictwem Internetu, często bywa ono zautomatyzowane i zdalne. Oprócz Internetu e-usługę można świadczyć także za pośrednictwem urządzeń mobilnych czy telewizji. Coraz szerszy wachlarz e-usług oferują instytucje ze sfery administracji publicznej, wychodząc naprzeciw oczekiwaniom klientów (zwłaszcza młodszego pokolenia) oraz wykorzystując rozwój cyfryzacji. Celem artykułu jest przedstawienie roli i opinii e-usługi w Zakładzie Ubezpieczeń Społecznych (ZUS), gdzie zaimplementowano liczne elektroniczne narzędzia usprawniające pracę oraz umożliwiające nawiązanie kontaktu, uzyskanie informacji, wysyłanie i odbieranie dokumentów. Wszystko to w celu zwiększenia dostępności dla potencjalnych i obecnych klientów, a także dla efektywniejszej pracy. Dla realizacji celu wykorzystano następujące metody badawcze: krytyczną analizę literatury, analizę danych statystycznych, analizę wyników ankiety (przeprowadzonej przez ZUS) oraz ankiety stanowiącej badania własn

A Case of Secondary Hemophagocytic Lymphohistiocytosis in a Patient With T-cell Lymphoma

Hemophagocytic lymphohistiocytosis (HLH) is a rare and life-threatening condition that results from excessive immune activation and inflammation. This condition may be triggered by various factors, including infections, malignancies, or autoimmune diseases. Here, we report the case of a 39-year-old male who developed HLH secondary to T-cell lymphoma and had a history of multiple autoimmune disorders. Our patient presented with shortness of breath and weakness which led to an admission for methicillin-resistant Staphylococcus aureus bacteremia. His hospital course deteriorated rapidly due to his worsening condition. He was confirmed to have HLH based on the HLH-2004 criteria with the presence of fever, splenomegaly, hypertriglyceridemia, hypofibrinogenemia, low natural killer cell function, high ferritin, and soluble interleukin 2 receptor levels. Peripheral blood smear and bone marrow biopsy showed atypical lymphocytes consistent with a T-cell lymphoma, but no hemophagocytosis. He was treated with dexamethasone and etoposide. Despite treatment, the patient passed away. This case aims to contribute further to the understanding of secondary HLH in the setting of T-cell lymphoma. It also illuminates how vital early recognition and treatment are in patients with secondary HLH

The Use of Adipose-Derived Stem Cells in Selected Skin Diseases (Vitiligo, Alopecia, and Nonhealing Wounds)

The promising results derived from the use of adipose-derived stem cells (ADSCs) in many diseases are a subject of observation in preclinical studies. ADSCs seem to be the ideal cell population for the use in regenerative medicine due to their easy isolation, nonimmunogenic properties, multipotential nature, possibilities for differentiation into various cell lines, and potential for angiogenesis. This article reviews the current data on the use of ADSCs in the treatment of vitiligo, various types of hair loss, and the healing of chronic wounds

Stem Cells as Potential Candidates for Psoriasis Cell-Replacement Therapy

Recent years have seen considerable progress in explaining the mechanisms of the pathogenesis of psoriasis, with a significant role played in it by the hyper-reactivity of Th1 and Th17 cells, Treg function disorder, as well as complex relationships between immune cells, keratinocytes, and vascular endothelium. The effect of stem cells in the epidermis and stem cells on T cells has been identified and the dysfunction of various types of stem cells may be a prime cause of dysregulation of the inflammatory response in psoriasis. However, exploring these mechanisms in detail could provide a chance to develop new therapeutic strategies. In this paper, the authors reviewed data on the role played by stem cells in the pathogenesis of psoriasis and initial attempts at using them in treatment