Действие местного иммунокорректора со свойствами вакцины НРС 19 на концентрацию перекиси водорода и активность миелопероксидазы в смывах из полости носа у больных с хроническим бронхитом

Twenty eight adults of both genders with chronic bronchitis participated in the open trial studying the influence of the local immune modulating drug IRS 19 with vaccine properties on polymorphonuclear leukocytes number, H202 concentration and myeloperoxidase activity in nasal washes. The polymorphonuclear leukocytes number increased from 4460±3960 to 10490±10950 cells per ml (p<0.02) after two months of IRS 19 use. This effect accompanied by the myeloperoxidase activity and the H202 concentration increase in 2.6 and 1.4 times, correspondingly (p<0.001). As the "polymorphonuclear leukocytes and myeloperoxidase – H202 – Clˉ " system is the first-line defence against pathogenic microorganisms, the changes mentioned above are likely to be one of the mechanisms enhancing the airways antibacterial immunity in response to the IRS 19 therapy.Двадцать восемь взрослых больных обоего пола, страдающие хроническим бронхитом, приняли участие в открытом исследовании, посвященном изучению эффекта применения местного иммуномодулирующего препарата со свойствами вакцины ИРС 19 на число полиморфноядерных лейкоцитов (ПМЯЛ), концентрацию Н202 и активность миелопероксидазы (МЛП) в смывах из полости носа. Число ПМЯЛ, выделявшихся из полости носа, увеличилось после двух месяцев применения ИРС 19 с 4460±3960 до 10 490±10 950 клеток на мл (р<0,02). Этот эффект сопровождался повышением активности МЛП и концентрации Н202, соответственно, в 2,6 и 1,4 раза (р<0,001). Поскольку система ПМЯЛ и МЛП – Н202 – CIˉ находится на переднем крае защиты от проникновения патогенных микроорганизмов, можно предположить, что упомянутые выше изменения могут представлять собой один из механизмов, приводящих к повышению антибактериального иммунитета в области дыхательных путей в ответ на лечение препаратом ИРС 19

Comparison of reorganized versus unaltered cardiology departments during the COVID-19 era: a subanalysis of the COV-HF-SIRIO 6 study

Background: Since the beginning of the coronavirus disease-2019 (COVID-19) pandemic, numerous cardiology departments were reorganized to provide care for COVID-19 patients. We aimed to compare the impact of the COVID-19 pandemic on hospital admissions and in-hospital mortality in reorganized vs. unaltered cardiology departments. Methods: The present subanalysis is a multicenter retrospective COV-HF-SIRIO 6 study that includes all patients (n = 101,433) hospitalized in 24 cardiology departments in Poland between January 1, 2019 and December 31, 2020, with a focus on patients with acute heart failure (AHF). Results: Reduction of all-cause hospitalizations was 50.6% vs. 21.3% for reorganized vs. unaltered cardiology departments in 2020 vs. 2019, respectively (p < 0.0001). Considering AHF alone respective reductions by 46.5% and 15.2% were registered (p < 0.0001). A higher percentage of patients was brought in by ambulance to reorganized vs. unaltered cardiology departments (51.7% vs. 34.6%; p < 0.0001) alongside with a lower rate of self-referrals (45.7% vs. 58.4%; p < 0.0001). The rate of all-cause in-hospital mortality in AHF patients was higher in reorganized than unaltered cardiology departments (10.9% vs. 6.4%; p < 0.0001). After the exclusion of patients with concomitant COVID-19, the mortality rates did not differ significantly (6.9% vs. 6.4%; p = 0.55). Conclusions: In cardiology departments reorganized to provide care for COVID-19 patients vs. unaltered ones, observed: i) a greater reduction in hospital admissions in 2020 vs. 2019; ii) higher rates of patients brought by ambulance and lower rates of self-referrals; and iii) higher all-cause in-hospital mortality for AHF due to COVID-19 related deaths

ORIGINAL PAPER<br> Erythropoietin therapy in chronic renal failure patients prior to hemodialysis

The human recombinant erythropoietin (hrEpo) is crucial in anemia treatment options in chronic renal failure patients undergoing regular hemodialysis therapy. However, the clinical characteristics of erythropoietin treatment prior to hemodialysis have not been thoroughly studied. This study was aimed to analyze in retrospective manner the results of hrEpo therapy in chronic renal failure prior to hemodialysis. The study included 42 patients (26 males and 16 females, 42.4±3.7 yrs old) with mean serum creatinine 305±32 µmol/l, whose anemia and iron homeostasis parameters were carefully assessed. HrEpo improved both the general state of the patients and the life quality, it decreased cardiovascular complications and the mortality of patients prior to hemodialysis therapy. Iron supplementation during erythropoietin therapy was required, in the majority of patients oral iron was sufficient. The application of human recombinant erythropoietin prior to hemodialysis is a safe option, it does not accelerate the progression of chronic renal failure, only in a small number of patients moderate increase of blood pressure was noted that could have been effectively managed with the modification of doses of hypotensive pharmacotherapy

ORIGINAL PAPER: <br>The lipid disorders therapy in overweight patients

Introduction: The study was aimed to assess effects of hypercholesterolemia and the dyslipidemia therapy within one year of recommended lifestyle and diet modifications. Material and methods: The study included 157 consecutive patients referred to the Outpatient Department of Metabolic Disorders with hypercholesterolemia diagnosis. Patients were assigned based on body weight and BMI into three groups: 1) patients with normal body weight (BMI 18.525-30) and 3) obese patients (BMI >30). The therapeutical effects were studied 6 and 12 months after the initiated therapy. The degree of body weight reduction, incidence and time frame of normal lipid panel, incidence and time of drop-outs in relation to the remaining IND and CVI risk factors were studied. Results: Total cholesterol was significantly increased before the study in overweight patients. After 6 months, the percentage of patients who reached the therapeutical targets was 30.56% in obese patients, 35.29% in overweight patients, and 29.41% in patients with normal body weight. After 12 months, the highest percentage of patients reaching therapeutical targets was 47.06% in the group with normal body weight. Conclusions: 1. Time frame and incidence of successful therapy and eventual, normal lipids panel is remarkably related with initial body weight. 2. Subjects with normal body weight benefited from the 12 months therapy to the largest extent. 3. Overweight and obese patients are less motivated to diet and lifestyle changes resulting in the highest number of patients with increased body weight during the dyslipidemia therapy

Original paper<br>The managed health care study for screening and early detection of colorectal cancer in Lodz urban population

The quality improvement initiative was undertaken in parallel with prospective studies on the incidence and frequency of colorectal cancer (CRC) in urban population of Lodz, Poland. The study was conducted in four primary care providers with the support of academic medical institutions. The study population included the citizens of Lodz, both genders, aged 45 to 65. The study was divided in two stages; each conducted consecutively in 2003 and 2004. This prospective, two stage study included 3152 patients. After positive serial guaiac-based fecal occult blood tests, high CRC odds ratio based on per rectum examination and the standardized questionnaire data 47.8% out of 1648 and 18.9% out of 1504 initially enrolled patients were enrolled into the extended diagnostic stage of the study within the consecutive years, respectively. CRC was found in 0.9% and 0.54% patients, respectively and the diagnosis of CRC was confirmed with histopathological tests. Colorectal diseases other than CRC were found in 23.1% and 11.2% of the study subjects, respectively. It is crucial to design and implement follow-up studies for those among our study subjects at high risk of CRC who finished the current study even without an unfavourable diagnosis or risk rating

Original paper <br>Thoracoscopic splanchnicectomy in chronic epigastric visceral pain therapy

Background: The rapid development of minimal invasive surgery in the 1990s coincided with the introduction of videothoracoscopic splanchnicectomy of nerve fibers engaged in the sensation of chronic pain related with advanced cancer. This study was aimed to determine pain intensity in patients with advanced cancer in the epigastric region before and after thoracoscopic splanchnicectomy. Material and methods: The thoracoscopic splanchnicectomy was performed in 33 patients aged 42 to 77 form 2001 to 2005. Patients with chronic epigastric pain due to advanced cancer were qualified for the surgery. The pain intensity was ranked with Prince Henry Hospital Pain Scale (PHHPS). Results: Even though all study patients were on continuous analgesic medications, the mean pain intensity in PHHPS scale was 2.67 points. Two days and thirty days after the surgery, the pain was ranked 1.28 and 1.57, respectively. All patients decreased the doses of their analgesic medication and seven of them entirely discontinued analgesic therapy. Conclusions: The thoracoscopic splanchnicectomy is well suited, although relatively little known, method of the therapy of chronic pain in advanced malignancy. It may be recommended as an option in the current palliative analgesic therapy

From Alpha to Delta—Genetic Epidemiology of SARS-CoV-2 (hCoV-19) in Southern Poland

In Poland, the first case of SARS-CoV-2 infection was confirmed in March 2020. Since then, many circulating virus lineages fueled rapid pandemic waves which inflicted a severe burden on the Polish healthcare system. Some of these lineages were associated with increased transmissibility and immune escape. Mutations in the viral spike protein, which is responsible for host cell recognition and serves as the primary target for neutralizing antibodies, are of particular importance. We investigated the molecular epidemiology of the SARS-CoV-2 clades circulating in Southern Poland from February 2021 to August 2021. The 921 whole-genome sequences were used for variant identification, spike mutation, and phylogenetic analyses. The Pango B.1.1.7 was the dominant variant (n = 730, 89.68%) from March 2021 to July 2021. In July 2021, the B.1.1.7 was displaced by the B.1.617.2 lineage with 66.66% in July 2021 and 92.3% in August 2021 frequencies, respectively. Moreover, our results were compared with the sequencing available on the GISAID platform for other regions of Poland, the Czech Republic, and Slovakia. The analysis showed that the dominant variant in the analyzed period was B.1.1.7 in all countries and Southern Poland (Silesia). Interestingly, B.1.1.7 was replaced by B.1.617.2 earlier in Southern Poland than in the rest of the country. Moreover, in the Czech Republic and Slovakia, AY lineages were predominant at that time, contrary to the Silesia region