Perforacja lewej komory serca u chorej z blokiem przedsionkowo-komorowym — opis przypadku

Heart perforation is rare but potentially fatal complication (about 1% of patients) after pacemaker, cardioverter-defibrillator or electrostimulations electrodes implantations. Complications in 81-years-old women after pacemaker implantation, reimplantation and endocavity electrode implantation with second-degree atrioventricular block is presented.Perforacja komory serca jest rzadkim (dotyczy ok. 1% chorych), ale bardzo poważnym powikłaniem, które może wystąpić po wszczepieniu układu kardiostymulującego. Zaprezentowano opis powikłań będących następstwem wszczepienia kardiostymulatora VVI oraz jego wymiany na elektrodę endokawitarną u 81-letniej chorej z blokiem przedsionkowo- -komorowym II stopnia

Expression of KIM-1, VEGF and bFGF in the transplanted kidney as predictive factors of kidney allograft function

Introduction: Transplantation is now a common treatment for kidney failure. However, it is associated with numerous complications, among which is rejection. Currently, factors that can predict the function of the transplanted kidney are being sought. This study aimed to investigate whether the expression of KIM-1 (kidney injury molecule-1), VEGF (vascular endothelial growth factor) and bFGF (basic fibroblast growth factor) assessed in the transplanted kidney before transplantation can be a predictive marker of the later function of the transplanted kidney and the occurrence of complications such as delayed graft function (DGF) and acute rejection (AR). Material and methods: The study group included 44 kidney allograft recipients who underwent kidney transplantation. Results: There were no statistically significant correlations between KIM-1, VEGF and bFGF gene expression in transplanted kidney biopsies and the occurrence of DGF and AR. The expression of the bFGF gene correlated significantly with the creatinine levels before and on the first day after transplantation. There were no statistically significant correlations between creatinine levels and expression of the KIM-1 and VEGF genes. There was also no statistically significant correlation between bFGF, KIM-1 and VEGF gene expression in the transplanted kidney and later eGFR and diuresis values. A statistically significant negative correlation was found between bFGF and serum potassium levels before transplantation and up to one month after transplantation. KIM-1 expression correlated significantly negatively with pre-transplant serum potassium levels. VEGF expression correlated significantly negatively with potassium levels 2 and 24 months after transplantation. Conclusions: The present results suggest that the expression of KIM-1, VEGF and bFGF assessed in the transplanted kidney before transplantation is not a significant predictor of the later function of the transplanted kidney. The expression of the bFGF gene correlates with the creatinine levels before and on the first day after transplantation. The expression of KIM-1, VEGF and bFGF may correlate with potassium serum levels

Polish Academy of Sciences

Polymorphism in the P-glycoprotein drug transporter MDR1 gene in renal transplant patients treated with cyclosporin A in a Polish populatio

A Case of Portomesenteric Venous Gas Detected on Computed Tomography

Portomesenteric vein gas is a rare condition, which patogenesis is not completly understood. One of causes is e.g. mesenteric ischemia. Patogenesis of this condition are: intraabdominal sepsis, interventional procedures, liver transplantation, Crohn disease and trauma. In 15% of causes its idiopatic. Hepatic portal venous gas predict high risk of mortality (>50%). An advanced radiology techniques such as computed tomography can be helpfull in recognizing of this pathology stage. We want to report a case of 83-year-old man with acute abdominal pain after cardiovascular procedure, with portomesenteric vein gas and bowel pneumatosis detected on computed tomography

The Role of Forkhead Box O in Pathogenesis and Therapy of Diabetes Mellitus

Type 2 diabetes is a disease that causes numerous complications disrupting the functioning of the entire body. Therefore, new treatments for the disease are being sought. Studies in recent years have shown that forkhead box O (FOXO) proteins may be a promising target for diabetes therapy. FOXO proteins are transcription factors involved in numerous physiological processes and in various pathological conditions, including cardiovascular diseases and diabetes. Their roles include regulating the cell cycle, DNA repair, influencing apoptosis, glucose metabolism, autophagy processes and ageing. FOXO1 is an important regulator of pancreatic beta-cell function affecting pancreatic beta cells under conditions of insulin resistance. FOXO1 also protects beta cells from damage resulting from oxidative stress associated with glucose and lipid overload. FOXO has been shown to affect a number of processes involved in the development of diabetes and its complications. FOXO regulates pancreatic β-cell function during metabolic stress and also plays an important role in regulating wound healing. Therefore, the pharmacological regulation of FOXO proteins is a promising approach to developing treatments for many diseases, including diabetes mellitus. In this review, we describe the role of FOXO proteins in the pathogenesis of diabetes and the role of the modulation of FOXO function in the therapy of this disease

IL17A and IL17F genes polymorphisms are associated with histopathological changes in transplanted kidney

Abstract Background Interleukin 17 is a proinflammatory cytokine involved in immune response after allograft transplantation. IL-17 family of proinflammatory cytokines includes IL-17A and IL-17F. Previous studies have demonstrated that the rs2275913 IL17A and the rs11465553 IL17F gene polymorphism are associated with kidney allograft function. Because of the association between these polymorphisms and post-transplant immune response, we assume that these single nucleotide polymorphisms may affect morphological structure of transplanted kidney. The aim of this study was to examine the association of rs2275913 IL17A and rs2397084, rs11465553 and rs763780 IL17F gene polymorphisms with histopathological changes in transplanted kidney biopsies such as: glomerulitis, tubulitis, arteritis, cell infilitration and fibrosis. Methods The study enrolled 82 patients after renal graft transplantation in whom a kidney biopsy was performed because of impaired graft function. The rs2397084 T > C (Glu126Gly), rs11465553 G > A (Val155Ile) and rs763780 T > C (His167Arg) polymorphisms within the IL17F gene and the rs2275913 A > G (− 197 A > G) polymorphism within the IL17A gene promoter were genotyped using TaqMan genotyping assays on a 7500 FAST Real-Time PCR System (Applied Biosystems, USA). Results There was a significant association between the rs2275913 IL17A gene polymorphism and the grade of tubulitis, which was more severe among patients with the A allele, compared to recipients with the GG genotype (GG vs. AG + AA, P = 0.02), and with the grade of arteriolar hyaline thickening and mesangial matrix increase, which were more severe among patients with the G allele compared to recipients with the AA genotype (AA vs. AG + GG, P = 0.01 and P = 0.04, respectively). Tubular atrophy and interstitial fibrosis were more severe among individuals with the C allele at the rs763780 IL17F gene polymorphism (TT vs. TC, P = 0.09 and P = 0.017, respectively). However, it should be taken into account that the statistical significance was achieved without correction for multiple testing, and no significant association would remain significant after such correction. Conclusions The results of this study may suggest a possible association between the rs2275913 IL17A and rs2275913 IL17A gene polymorphisms and some histopathological changes in transplanted kidney biopsies

Artykuł oryginalnyPonowne hospitalizacje pacjentów z implantowanym kardiowerterem-defibrylatorem serca

Introduction: Hospital readmissions are one of the important problems of patients with implantable cardioverter-defibrillators (ICD). Detailed analysis of the causes of rehospitalisations may lead to improved management of ICD patients and eventually limit the number of hospital readmissions. Aim: Prospective analysis of repeat hospitalisations, their causes and time from discharge to first hospital readmission in a group of patients after ICD implantation. A search for predictors of rehospitalisation was also performed. Methods: Analysis involved 133 consecutive patients who underwent ICD implantation in the Department of Cardiology, PAM. Readmission causes were split into cardiac and non-cardiac. An index of repeat hospitalisation was calculated and parameters with a direct impact on rehospitalisation necessity were also evaluated. Results: One hundred and sixty-seven hospital readmissions of 72 (54%) patients were noted at mean 22±15 months after the primary hospitalisation. Rehospitalisation index per patient for the total follow-up period was 1.26, while for the first year of follow-up it was 0.69. In the case of 42 (32%) patients, 91 (54.5%) hospital readmissions were associated with arrhythmia. In 34 (25.6%) patients, 54 (32.3%) rehospitalisations were not related to arrhythmia, while 20 (15%) patients were hospitalised 22 times (13.2%) for non-cardiac reasons. Mean time to the first readmission, regardless of the reason, was 9±9 months. Predominant causes of repeat hospitalisation were ventricular arrhythmias and worsening of heart failure. Patients with left ventricular ejection fraction (LVEF) below 30% and in functional NYHA class III were readmitted to hospital more frequently for reasons not related to arrhythmia. Conclusions: Hospital readmissions for cardiac causes in patients after ICD implantation are still frequent. Most of them are caused by ventricular arrhythmia and heart failure. Low LVEF (Wstęp: Rehospitalizacje są jednym z istotnych problemów u chorych ze wszczepionym kardiowerterem-defibrylatorem (implantable cardioverter defibrillator, ICD). Dokładna analiza przyczyn rehospitalizacji może wpływać na poprawę postępowania u chorych z ICD i ograniczyć ich liczbę. Cel: Prospektywna analiza częstości, przyczyn i czasu do pierwszej rehospitalizacji chorych po implantacji kardiowertera-defibrylatora (ICD). Poszukiwano również czynników predysponujących do ich wystąpienia. Metodyka: Analizą objęto 133 kolejnych chorych, którym wszczepiono ICD w Klinice Kardiologii PAM. Przyczyny rehospitalizacji podzielono na kardiologiczne i niekardiologiczne. Obliczono współczynnik rehospitalizacji oraz zbadano, które parametry miały niezależny wpływ na konieczność rehospitalizacji. Wyniki: Zaobserwowano 167 ponownych hospitalizacji u 72 (54%) pacjentów po średnio 22±15 mies. Współczynnik rehospitalizacji przypadający na pacjenta podczas całego okresu obserwacji wyniósł 1,26, natomiast podczas roku 0,69. U 42 (32%) pacjentów wystąpiło 91 (54,5%) ponownych przyjęć do szpitala z powodów związanych z arytmią. U 34 (25,6%) chorych stwierdzono 54 (32,3%) rehospitalizacji niezwiązanych z arytmią, a 20 (15%) pacjentów hospitalizowano z przyczyn niekardiologicznych, rejestrując 22 (13,2%) takich hospitalizacji. Œredni czas do wystąpienia pierwszej hospitalizacji, niezależnie od jej przyczyny, wyniósł 9±9 mies. Głównymi powodami, z których pacjentów przyjmowano do szpitala, były arytmie komorowe i niewydolność serca. Ustalono, iż pacjenci z frakcją wyrzutową lewej komory (LVEF) poniżej 30% oraz z dolegliwościami w III klasie NYHA byli częściej hospitalizowani z przyczyn niezwiązanych z arytmią. Wnioski: Hospitalizacje z przyczyn kardiologicznych u pacjentów po implantacji ICD są nadal częstym zjawiskiem. Większość z nich jest spowodowana arytmiami komorowymi oraz niewydolnością serca. Niska LVEF

<i>Epilobium angustifolium</i> L. Essential Oil—Biological Activity and Enhancement of the Skin Penetration of Drugs—In Vitro Study

Epilobium angustifolium L. is a popular medicinal plant found in many regions of the world. This plant contains small amounts of essential oil whose composition and properties have not been extensively investigated. There are few reports in the literature on the antioxidant and antifungal properties of this essential oil and the possibility of applying it as a potential promoter of the skin penetration of drugs. The essential oil was obtained by distillation using a Clavenger type apparatus. The chemical composition was analyzed by the GC-MS method. The major active compounds of E. angustifolium L. essential oil (EOEa) were terpenes, including α-caryophyllene oxide, eucalyptol, β-linalool, camphor, (S)-carvone, and β-caryophyllene. The analyzed essential oil was also characterized by antioxidant activity amounting to 78% RSA (Radical Scavenging Activity). Antifungal activity against the strains Aspergillus niger, A. ochraceus, A. parasiticum, and Penicillium cyclopium was also determined. The largest inhibition zone was observed for strains from the Aspergillus group. The EOEa enhanced the percutaneous penetration of ibuprofen and lidocaine. After a 24 h test, the content of terpene in the skin and the acceptor fluid was examined. It has been shown that the main compounds contained in the essential oil do not penetrate through the skin, but accumulate in it. Additionally, FTIR-ATR analysis showed a disturbance of the stratum corneum (SC) lipids caused by the essential oil application. Due to its rich composition and high biological activity, EOEa may be a potential candidate to be applied, for example, in the pharmaceutical or cosmetic industries. Moreover, due to the reaction of the essential oil components with SC lipids, the EOEa could be an effective permeation enhancer of topically applied hydrophilic and lipophilic drugs

Genetic variants of progesterone receptor in etiology of preterm delivery

Objectives:  Preterm delivery (PTD) accounts for around 11% of pregnancies worldwide. Unfortunately, no diagnostic indicator, specific mechanism or genetic predisposition has yet been identified. One of the hypotheses suggest local or functional progesterone decrease as a potential reason for preterm uterine contractions leading to preterm delivery. It is believed that any change in progesterone receptor DNA may be crucial for higher risk of preterm delivery due to abnormal response to prostaglandins, normally inhibited by properly built progesterone. The aim of this study was to determine whether there is an association between progesterone gene polymorphisms (PROGINS and +331G/A) and preterm birth. Material and methods: A total of 230 women were enrolled, including 115 cases of preterm deliveries (between 22 and 36 weeks of gestation) and 115 healthy mothers of full-term infants. Genomic DNA was isolated from the blood sample. Polymerase chain reaction (PCR) amplification was carried out in a final volume of 25µL. Genotyping was assayed by PCR. Statistical analysis of the results was conducted with p &lt; 0.05 accepted as statistically significant. Results: For both PROGINS (Alu ins/del) and +331G/A (rs10895068) polymorphisms were equally frequent in case and control group. The prevalence of PGR alleles in both groups was also comparable. Conclusions: The results of our study showed no association between progesterone gene polymorphisms (PROGINS and +331G/A) and risk of preterm delivery. Identifying mechanisms to prolong the length of gestation, particularly in women at risk for preterm delivery, will improve both maternal and fetal outcomes.