The analysis of Sudden Infant Death Syndrome in Poland

Introduction: Sudden Infant Death Syndrome is defined in literature similarly as a sudden and unexpected death of an infant occurring during sleep and, at the same time, causes of which cannot be explained based on anamnesis, circumstances of death or comprehensive post-mortem examinations. Sudden Infant Death Syndrome is considered to be the most frequent cause of death among infants in the developed countries. Incidence of SIDS in the whole world ranges from about 0.1 to 6.0/1,000 live births. As much as 90% concerns deaths in the first year of life of a child, whereas 70% stands for deaths for which the cause remains unknown. In SIDS, about 90% of cases concern children under 1 year old and, in particular, at the age of between 2 and 4 months.The aim: The aim of the study was to present the most significant aspects of SIDS as well as description and analysis of risk factors for occurrence of sudden infant death syndrome based on statistical data.Materials and methods: For the purpose of the study, the secondary data analysis and desk research technique have been applied. The analysis is based on statistical data from the time period 2009-2014 released by the Central Statistical Office of Poland.Results: In 2009-2014, the highest number of deaths of infants and new-borns was reported in 2009 with the number being as high as 2,327. In the following years, the number of deaths of new-borns and infants systematically decreased. In 2010 it was 2,057 and in 2011 – 1,836, in 2012 – 1,791, in 2013 – 1,684, and in 2014 – 1,583. The highest number of deaths of boys was reported in 2009 – 1,298, while the number of deaths of girls in that year, although it was the highest in the analysed period, was lower – 1,029.Conclusions: cases of death were more frequent among boys rather than girls. The highest number of deaths was reported among infants under the age of one month and the number decreased with an increasing infants’ age. More cases of death were reported in the city area rather than in a village

Treatment of chronic myelogenous leukemia – current status and future prospects

Wprowadzenie imatynibu do terapii przewlekłej białaczki szpikowej (PBSz) można już z perspektywy ponad dekady ocenić jako jedno z przełomowych wydarzeń w leczeniu nowotworów i w historii onkologii. Drobnocząsteczkowy inhibitor swoiście hamujący aktywność onkogennej kinazy tyrozynowej BCR/ABL, odpowiedzialnej za transformację nowotworową komórki macierzystej krwiotworzenia, okazał się zaskakująco skuteczny u większości chorych i zrewolucjonizował terapię PBSz. Niestety znacząca grupa chorych z powodu wystąpienia oporności lub nietolerancji nie odnosi spodziewanych korzyści terapeutycznych, co powoduje, że jednym z głównych celów badań stało się poszukiwanie nowych, jeszcze skuteczniejszych leków. W ostatnich 5 latach do terapii wprowadzono inhibitory drugiej generacji (dasatynib, nilotynib, bosutynib), trwają badania kliniczne nad inhibitorami trzeciej generacji (np. ponatynib hamujący zmutowaną kinazę BCR/ABL z mutacją T315I) oraz inhibitorami allosterycznymi, które hamują kinazę w innym mechanizmie, nie wiążąc się z jej centrum aktywnym. Żaden z dotychczas badanych leków nie eliminuje macierzystych komórek białaczkowych będących źródłem choroby, dlatego obecnie uważa się, że leczenie musi być kontynuowane dożywotnio. Ponieważ celem dla terapii powinno być całkowite wyleczenie chorego i możliwość przerwania leczenia, trwają badania nad możliwością całkowitej eradykacji białaczki, przez zastosowanie terapii łączonych. Można mieć nadzieję, że tak jak sukces imatynibu w terapii PBSz wyznaczył nowy kierunek w onkologii, tak samo osiągnięcie celu w postaci całkowitego wyleczenia pomoże w znalezieniu skutecznej terapii w innych nowotworach.Introduction of imatinib to the treatment of chronic myelogenous leukemia (CML) more than a decade ago may be considered as one of the milestones in the history of cancer treatment and oncology. Small molecule inhibitor, which specifically inhibits BCR/ABL oncogenic tyrosine kinase, responsible for malignant transformation of hematopoietic stem cell proved to be unexpectedly effective in the majority of patients and has revolutionized CML therapy. Unfortunately, a significant group of patients develops resistance or is intolerant to the drug which necessitate search for new better drugs. In the last 5 years 2nd generation inhibitors have been approved (dasatinib, nilotinib and bosutinib), clinical trials are ongoing with 3rd generation inhibitors (among them ponatinib, active against BCR/ABL with T315I mutation) and allosteric inhibitors. None of the available drugs eliminates leukemia stem cells, which are the roots of the disease, therefore therapy must be continued indefinitely. Since ultimate goal is to cure the disease there are number of trials to eradicate the disease with combination therapies. We may expect that such like imatinib opened new therapeutic horizons in oncology, complete eradication of CML will help to find cure other cancers

Psychoactive substance use in patients diagnosed with attention-deficit/hyperactivity disorder: an exploratory study

IntroductionAttention-deficit/hyperactivity disorder (ADHD) was originally treated as a neurodevelopmental disorder that occurs mainly in children and tends to diminish or disappear with age, but we now know that symptoms persist into adulthood in over 50% of ADHD patients. Undiagnosed individuals often turn to psychoactive substance to minimize the negative aspects of functioning and improve quality of life.MethodsThe study was conducted online using random sampling through a Facebook group administered by physicians and targeted to patients diagnosed with ADHD. The study was naturalistic and exploratory, therefore no hypothesis was made. 438 correctly completed questionnaires were received. Analysis of the results showed that people with ADHD turn to psychoactive substances relatively frequently.ResultsThe most commonly used stimulants include alcohol, marijuana, 3,4-methylenedioxymethamphetamine (MDMA), amphetamine/methamphetamine, and psilocybin. In the study population, methylphenidate is the most commonly used drug among patients. After treatment with psychostimulants, the majority of respondents note a decrease in symptoms of hyperactivity disorder, especially in male patients.ConclusionIt is necessary to perform proper diagnostics and actively look for ADHD symptoms in patients who tend to use psychoactive substances

Vertical distribution of the root system of linseed (Linum usitatissimum L.) and legumes in pure and mixed sowing

Root competition for below-ground resources between edible plants may provide for long-term sustainability of agriculture systems. Intercropping can be more productive than a pure crop due to taking advantage of the morphological differences between species. In pure cropping, all biophysical interactions between plants occur through soil conditions. In intercropping, competition for water and nutrients is of major importance, but if the roots of one species occupy the zone just underneath the roots of the other crop, they can better use the resources of the root zone of the crop. The root system demonstrates a high degree of plasticity in its development in response to local heterogeneity of the soil profile and plant density. This study aimed at determining: (i) the morphological characteristics of the root systems of linseed, pea and vetch depending on the method of sowing; (ii) the root distribution in various soil types and at different soil profile depths (0–15 cm, 15–30 cm). Two three-year field experiments were conducted on two soil types in south Poland: soil A – Luvic Phaeozem (s1) and soil B – Eutric Cambisol (s2). These results show that linseed was more aggressive toward both legumes in mixture, but it produced lower yield compared to pure cropping. The environmental stress of plants in mixtures increased the relative weight of roots, which resulted in decreasing the root-shoot ratio (RSR)

Clinical application of stress echocardiography in valvular heart disease

ABSTRACT Valvular heart diseases (VHDs) constitute an increasing problem both as a consequence of population aging and as the sequelae of other heart diseases. Accurate diagnosis is essential for correct clinical decision‑making; however, in many patients, transthoracic and transesophageal echocardiography is insufficient. Stress echocardiography (SE) proved to be a useful tool allowing for simultaneous assessment of left ventricular contractile reserve and HVD hemodynamics under conditions of physiological or pharmacological stress. It is recommended for assessing the severity of VHD, guiding the choice of treatment, as well as for surgical risk stratification. It can be applied both in asymptomatic patients with severe VHD and in symptomatic individuals with moderate disease. In patients with VHD, SE can be performed either as exercise stress echocardiography (ESE) or dobutamine stress echocardiography (DSE). The first modality is recommended to unmask symptoms or abnormal blood pressure response in patients with aortic stenosis (AS) who report to be asymptomatic or in those with mitral stenosis with discordance between clinical symptoms and the severity of valve disease on transthoracic echocardiography. In asymptomatic patients with paradoxical low‑flow, low‑gradient (LFLG) AS, ESE can be used to assess the severity of stenosis. On the other hand, low‑dose DSE can be a useful diagnostic tool in classical LFLG AS, providing information on stenosis severity and contractile reserve. Moreover, SE is indicated in patients with prosthetic valve when there is discordance between symptoms and echocardiographic findings. It is also recommended in high‑risk surgical patients with VHD with poor functional capacity and more than 2 clinical risk factors. The present paper discusses in detail the use of SE in VHD

The influence of plant mulches on the content of phenolic compounds in soil and primary weed infestation of maize

In growing maize, an increase in the content of phenolic compounds and selected phenolic acids in soil was found after the incorporation of white mustard, buckwheat, spring barley, oats and rye mulches into the soil. The highest content of phenolic compounds in soil was found after oats mulch incorporation (20% more than in the control soil). The highest content of selected phenolic acids was found for the soil with the oats and rye mulch. Among the phenolic acids investigated, ferulic acid was most commonly found in the soil with the plant mulches. However, two phenolic acids: the protocatechuic and chlorogenic acid, were not detected in any soil samples (neither in the control soil nor in the mulched soil). At the same time, a decrease in the primary weed infestation level in maize was found in the plots with all the applied plant mulches, especially on the plots with oats, barley and mustard. The plant mulches were more inhibitory against monocotyledonous weeds than dicotyledonous ones. During high precipitation events and wet weather, a rapid decrease in the content of phenolic compounds in soil and an increase in the primary weed infestation level in maize were observed

Association between calcifications of mitro-aortic continuity and mitral regurgitation in patients undergoing transcatheter aortic valve replacement

Background: The presence of mitral annular calcification (MAC) affects prognosis in patients undergoing transcatheter aortic valve implantation (TAVI). MAC frequently coexists with calcifications of mitro-aortic continuity (CMAC).Aims: We aimed at qualitative and semi-quantitative analysis of calcifications of the mitral complex — MAC and CMAC in multi-slice computed tomography, in order to assess their impact on the occurrence and dynamics of mitral regurgitation (MR) following TAVI.Methods: The study group consisted of 94 patients (mean [SD] age was 79.9 [8.02] years; 67.1% female). Agatston scale — Calcium Score was used for quantitative analysis. MAC and CMAC were also assessed semi-quantitatively as either non-severe or severe. MR following TAVI was defined as unchanged, improved or worsened by at least one degree.Results: Patients with MAC (59.6%) had higher mean aortic gradients (P = 0.02) and smaller left ventricular diastolic diameter (P = 0.002). Patients with CMAC (48.9%) had higher Calcium Score aortic valve (P = 0.006). After TAVI MR improved in 17 (18.1%) patients and worsened in 7 (7.5%) patients. In multivariable logistic regression analysis MR worsening was associated with higher CMAC (OR, 1.092; 95% CI, 1.006–1.185; P = 0.03), as well as bicuspid aortic valve (OR, 6.348; 95% CI, 1.048–38.436; P = 0.04).Conclusions: CMAC was associated with MR worsening following TAVI. This is of relevance in procedural planning in patients with severe aortic stenosis (AS) and coexisting MR in whom arguments for and against surgical repair of concomitant mitral insufficiency are considered

Predictors of aortic stenosis severity reclassification using an imaging data fusion method in patients referred for transcatheter aortic valve implantation

Background: The use of imaging data fusion method (IDFM) with multislice computed tomography (MSCT) and two-dimensional transthoracic echocardiography (2D-TTE) in patients with aortic stenosis (AS) may result in reclassification of AS severity from severe to non-severe. Aim: We sought to establish potential predictors of AS severity reclassification using the IDFM method. Methods: A total of 54 high-risk patients (mean age 79 ± 7.9 years; 40.7% male) with severe AS by 2D-TTE (indexed aortic valve area [AVAi] < 0.6 cm2/m2), referred for transcatheter aortic valve implantation, were included in the analysis. AVAi was subsequently recalculated using IDFM by replacing 2D-TTE left ventricular outflow tract (LVOT) measurements with MSCT LVOT parameters. Results: Imaging data fusion method reclassified 20.4% patients into the potentially non-severe AS group. In a multivariable model including clinical variables, reclassification to non-severe AS by IDFM was independently associated with younger age and diabetes mellitus (DM), (odds ratio [OR] 0.864; 95% confidence interval [CI] 0.76–0.99; p < 0.035 and OR 19.259; 95% CI 2.28–162.41; p < 0.007, respectively). In a multivariable analysis of echocardiographic variables, reclassification was associ­ated with higher LVOT velocity time integral and lower aortic mean gradient (OR 1.402; 95% CI 1.07–1.84; p < 0.014 and OR 0.858; 95%: CI 0.760–0.968; p < 0.013, respectively). In addition, 24.1% of patients were reallocated from low-flow (< 35 mL/m2) to normal-flow AS. Conclusions: Imaging data fusion method reclassified a substantial proportion of patients with severe AS into a potentially moderate AS group and from a low-flow to a normal-flow AS group. Such regrouping calls for increased diagnostic prudence in AS patients, especially those with specific clinical and echocardiographic predictors of reclassification, such as DM or low aortic mean gradient

Genomic landscape of human erythroleukemia K562 cell line, as determined by next-generation sequencing and cytogenetics

We have performed detailed analysis of the genomic landscape of commercially available K562 cells, employing targeted enrichment of nearly 1300 cancer-related genes followed by next-generation sequencing (NGS) and also classical cytogenetics. Deep sequencing revealed 88 variants of potentially biological significance. Among them we have detected alterations in genes already known to be mutated in K562, such as TP53 but also in several other genes, which are implicated in tumorigenesis and drug resistance, such as MLH1, ASXL1 and BRCA1 as the most prominent examples. Fluorescence in situ hybridization (FISH) of interphases of K562 cells revealed multiplication of the BCR and ABL1 gene copies, as well as the amplification of the BCR-ABL1 fusion gene. Our results may help to better understand genomic instability of the blastic phase of CML represented by the K562 cell line and can help researchers who want to employ this cell line in various experimental settings

Bridging the divide : addressing discrepancies between clinical guidelines, policy guidelines, and biomarker utilization

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