Model-based reconstruction and projections of soil moisture anomalies and crop losses in Poland

Evidence shows that soil moisture (SM) anomalies (deficits or excesses) are the key factor affecting crop yield in rain-fed agriculture. Over last decades, Poland has faced several major droughts and at least one major soil moisture excess event leading to severe crop losses. This study aims to simulate the multi-annual variability of SM anomalies in Poland, using a process-based SWAT model and to assess the effect of climate change on future extreme SM conditions, potentially affecting crop yields in Poland. A crop-specific indicator based on simulated daily soil moisture content for the critical development stages of investigated crops (winter cereals, spring cereals, potato and maize) was designed, evaluated for past conditions against empirical crop-weather indices (CWIs), and applied for studying future climate conditions. The study used an ensemble of nine bias-corrected EURO-CORDEX projections for two future horizons: 2021–2050 and 2071–2100 under two Representative Concentration Pathways: RCP4.5 and 8.5. Historical simulation results showed that SWAT was capable of capturing major SM deficit and excess episodes for different crops in Poland. For spring cereals, potato and maize, despite a large model spread, projections generally showed increase of severity of soil moisture deficits, as well as of total area affected by them. Ensemble median fraction of land with extreme soil moisture deficits, occupied by each of these crops, is projected to at least double in size. The signals of change in soil moisture excesses for potato and maize were more dependent on selection of RCP and future horizon. © 2020, The Author(s)

Czy istnieje różnica w jakości życia i występowaniu objawów psychiatrycznych u chorych na akromegalię i inne choroby przewlekłe?

Introduction: The study aimed to evaluate the psychological profile of patients with acromegaly in comparison to other chronic diseases such as non-functioning pituitary adenomas, Cushing disease, and plaque psoriasis, and to a healthy control group. Material and methods: A total sample of 153 participants in clinical groups underwent a cross-sectional assessment including the quality of life (AcroQoL, WHOQoL-BREF), psychiatric morbidity (GHQ-28), and the acceptance of illness (AIS), as well as 65 participants in the healthy control group. Results: The whole study sample had a predominance of urban married females (61%) with medium level of education (41%). Patients with acromegaly were diagnosed significantly later than patients from other clinical groups, after the onset of the first symptoms. Acromegaly was related to the presence of more symptoms of anxiety and insomnia, and poorer social relationships compared with the general population but not more than in other chronic diseases. A better quality of life score in all domains of WHOQoL-BREF was associated with a better score on the acceptance of illness scale and lower scores on GHQ-28. Conclusions: Psychiatric morbidity, mainly anxiety and insomnia, occurs in 50% of patients with acromegaly. However, the psychological wellbeing and mood seem to be related to other factors such as the acceptance of the illness. Thus, concerning the diagnosis, treatment, and monitoring of acromegaly an interdisciplinary approach, taking into account psychological and psychiatric consultation, is needed.Wstęp: Celem pracy była ocena profilu psychologicznego pacjentów z akromegalią w porównaniu z pacjentami z innymi chorobami przewlekłymi, takimi jak: nieczynne hormonalnie gruczolaki przysadki, choroba Cushinga, łuszczyca oraz zdrowych z grupy kontrolnej. Materiał i metody: Badaniem objęto 153 chorych w grupach klinicznych, którzy zostali poddani szerokiej ocenie obejmującej: jakość życia (AcroQoL, WHOQoL-BREF), występowanie zaburzeń psychiatrycznych (GHQ-28) i stopień akceptacji choroby (AIS) oraz 65 uczestników z grupy kontrolnej. Wyniki: W całej grupie badanej obserwowano przewagę zamężnych, miejskich kobiet (61%) z wykształceniem średnim (41%). Pacjenci z akromegalią byli diagnozowani znacznie później w stosunku do pozostałych grup chorych, po pojawieniu się pierwszych objawów. Akromegalia charakteryzowała się częstszym występowaniem bezsenności i lęku oraz gorszymi relacjami społecznymi w porównaniu z populacją ogólną, ale nie w stosunku do innych chorób przewlekłych. Lepsza jakość życia we wszystkich domenach formularza WHOQoL-BREF wiązała się z większą akceptacją choroby i niższym wynikiem w skali GHQ-28. Wnioski: Zaburzenia psychiatryczne, głównie lęk i bezsenność, występują u 50% pacjentów z akromegalią. Jednak stan psychiczny i nastrój wydają się związane z innym czynnikiem, jakim jest stopień akceptacji choroby. Podkreśla to potrzebę opieki interdyscyplinarnej, uwzględniającej opiekę psychiatryczną i psychologiczną, w diagnostyce, leczeniu i monitorowaniu pacjentów z akromegalią

Factors predisposing to non-tuberculous mycobacterial lung disease in the patients with respiratory isolates of non-tuberculous mycobacteria.

Introduction: An increasing incidence rate of respiratory isolates of non-tuberculous mycobacteria (NTM) has been noted recentlyin most European countries as well as in the US. Despite many publications, there is no consensus concerning the importance ofdifferent factors in promoting NTM lung disease (NTMLD).The aim of the present retrospective study was to analyse patients with positive NTM respiratory isolates in search of factorspredisposing to NTMLD. Material and methods: 73 patients, 23 males, 50 females, median age 62.2 years, in whom NTM have been cultured fromrespiratory specimen (sputum and/or bronchial washings), in the period 2010–2015, entered the study. Results: NTMLD (according to ATS/IDSA) has been recognised in 36 patients, airways colonisation by NTM — in 37 patients. NTMLDwas diagnosed more often in the patients infected with M. kansasii, M. abscessus and M. avium/M. intracellulare comparing to thoseinfected with M. xenopi, M. gordonae and M. fortuitum (p < 0.0001). The proportion of females to males was significantly higher inthe NTMLD group comparing to the colonisation group (p < 0.007). Previous tuberculosis or mycobacteriosis were noted significantlymore frequently in the group of patients with NTMLD comparing to the colonisation group (28% vs 8%, p = 0.038). Univariate regressionanalysis revealed M. kansasii, female gender, and previous tuberculosis or mycobacteriosis as significant predictors of NTMLD. Conclusions: The risk factors of NTMLD recognition in the presented group of patients were the following: female gender,M. kansasii isolation, as well as past tuberculosis or mycobacteriosis

Endocrine-related adverse events associated with targeted treatment and immune checkpoint blockage in hematological malignancies

The introduction of tyrosine kinase inhibitors and immune checkpoint inhibitors considerably improved the treatment of many hematological malignancies. However, these new classes of drugs are associated with novel hitherto not observed endocrine-related adverse effects. Therefore, this review aims to get insight into the pathogenesis of endocrine-related AEs and summarize their management according to the current European recommendations

Impact of prior statin therapy on evaluation of the inflammatory process and cortisol concentration in patients with the first ST-segment elevation myocardial infarction undergoing coronary angioplasty with bare metal stent implantation

Introduction. The aim of the current study was to verify the impact of statin therapy on evaluation of the inflammatory process and cortisol concentration in patients with the first episode of ST-segment elevation myocardial infarction undergoing coronary angioplasty with bare metal stent implantation. Material and methods. The study was designed as a prospective, single-center cohort study, with a total number of 200 patients enrolled between 2005 and 2008. Results. Seventeen patients with ongoing statin therapy and 167 patients without those agents underwent pPCI with BMS implantation. The cortisol concentration on admission was significantly lower in statin therapy subgroup — median 14.9 μg/dL (9.5–23.3 IQR) vs. 28,1 μg/dL (17.2–39.9 IQR) for patients without lipid lowering drug, p = 0.01. The level of cortisol after 23h was also significantly lower in statin receiving subgroup: 10.4 μg/dL (8.3–19 IQR) vs. 17.3 μg/dL (10.1–25.9 IQR) adequately, p = 0.021. Those two groups did not differ significantly in relation to CRP, IL-6, IL-10 concentrations and to anti-inflammatory cytokine ratio [IL-6/IL-10] on admission, after 24h and at discharge. Significant differences were observed in the concentrations of cTnI and activities of CK and CK-MB. Conclusions. Ongoing statin therapy before an episode of myocardial infarction has an influence on cortisol concentration and cardiac markers. No significant effect on serum levels of cytokines has been observed.

Mutacja spontaniczna w obrębie genu TCF2 przyczyną cukrzycy MODY5 — prezentacja przypadku klinicznego

  MODY5 is one of the less common forms of MODY (1–2%). It is a genetic disorder inherited through an autosomal dominant mutation or deletion of the hepatocyte nuclear factor-1beta gene. MODY5 is associated with genital tract malformations such as hypoplasia of uterus, hypoplasia of vagina, bicornuate uterus, other uterine malformations, hypospadias and atresia of vas deferens. Moreover, moderate idiopathic hyperuricaemia, elevated liver function tests (ALT, GGTP) without jaundice and with normal ultrasound image of the liver, pancreatic atrophy and pyloric stenosis were found in some patients. Objective: Description of the maturity-onset diabetes of the young type 5 (MODY5), a rare type of diabetes. A 30-year-old woman, with no family history of diseases, was repeatedly seen by various healthcare professionals because of her numerous non-specific symptoms: pain in the forehead, stomach pain, retrosternal pain, lower limbs pain, reduced right eye visual acuity, dizziness, photosensitivity, syncope, diarrhoea, nausea, weight loss, fatigue, action tremor of the whole body most prominent in the right upper limb and muscle weakness most notable in the morning. She was diagnosed with diabetes and was initiated on insulin therapy. Blood samples were taken for immunological and genetic investigations. Testing revealed the patient is heterozygous for mutation of deletion of the hepatocyte nuclear factor-1beta gene, that is MODY5 gene. The patient was switched to OHA therapy. The mutation of factor-1beta was not found in the patient’s family. Ultrasound scanning of the abdomen revealed a 12 mm cyst with massive wall calcification in the right kidney and one cyst with solid component and three small, simple cysts in the central part of the left kidney. It also showed a 50 mm right ovarian cyst, bicornuate uterus and a vaginal fibroma. Skin lesions on the right shin were identified as necrobiosis lipoidica. Laboratory tests showed high urine pH and periodic electrolyte disturbances such as hypokalemia. Differential diagnosis that includes monogenic forms of diabetes may lead to optimization of treatment and more accurate evaluation of prognosis for patients and their family members.    Cukrzyca MODY5 stanowi jeden z rzadszych typów cukrzycy typu MODY (1–2%). Jest chorobą genetycznie uwarunkowaną, dziedziczoną jako cecha autosomalna dominująca, związaną z mutacją lub delecją hepatocytowego czynnika jądrowego HNF-1b kodowanego. Cukrzycy MODY5 mogą towarzyszyć wady rozwojowe układu rozrodczego, takie jak: niedorozwój macicy, pochwy, macica dwurożna, inne malformacje macicy, spodziectwo, atrezja nasieniowodów. Ponadto u części pacjentów wykazano umiarkowaną hiperurykemię o niewyjaśnionej etiologii, podwyższone wartości ALT i GGTP bez żółtaczki oraz zmiany w USG wątroby, atrofię trzustki i zwężenie odźwiernika. Celem pracy jest prezentacja rzadkiej postaci cukrzycy, jaką stanowi cukrzyca typu MODY5. Chora, lat 30, bez wywiadu rodzinnego w kierunku chorób przewlekłych, wielokrotnie diagnozowana w różnych placówkach leczniczych z powodu licznych, niespecyficznych dolegliwości bólowych: okolicy czołowej głowy, brzucha, okolicy zamostkowej oraz kończyn dolnych, pogorszenia ostrości widzenia oka prawego, zawrotów głowy, nadwrażliwości na światło, omdleń, biegunek, nudności, spadku masy ciała, osłabienia, drżenia wysiłkowego całego ciała z przewagą drżenia wysiłkowego prawej kończyny górnej, osłabienia siły mięśniowej kończyn, głównie w godzinach porannych. Diagnostyka zaburzeń endokrynnych ujawniła cukrzycę. Rozpoczęto leczenie insuliną oraz pobrano krew na badania immunologiczne i genetyczne, które ujawniły, że pacjentka jest heterozygotą dla mutacji delecji genu HNF-1beta, czyli jest to cukrzyca typu MODY5. Zmieniono leczenie na doustny lek hipoglikemizujący. W rodzinie nie wykryto mutacji czynnika HNF-1beta. U opisywanej chorej w badaniu USG jamy brzusznej w obrębie nerki prawej uwidoczniono torbiel o średnicy około 12 mm z dużymi zwapnieniami w ścianie, natomiast w nerce lewej w części centralnej torbiel z gęstą zawartością oraz trzy drobne torbiele proste. Stwierdzano również obecność torbieli jajnika prawego o średnicy około 50 mm, macicę dwurożną oraz włókniaka w obrębie pochwy. Na prawej goleni występowały zmiany na skórze o charakterze necrobiosis lipoidica. W badaniach laboratoryjnych uwagę zwracało wysokie pH moczu i okresowo pojawiające się zaburzenia elektrolitowe w postaci hipokalemii. Uwzględnienie w diagnostyce różnicowej cukrzycy jej form monogenowych może się przyczynić do optymalizacji leczenia oraz ustalenia właściwego rokowania u pacjenta i członków jego rodziny.

Effects of Nordic Walking on Oxidant and Antioxidant Status: Levels of Calcidiol and Proinflammatory Cytokines in Middle-Aged Women

Objectives. Nordic walking (NW) is relatively new and popular type of physical exercise with less studied effects than other sports activities. The aim of the study was to analyze possible changes in somatic indices, oxidant and antioxidant status, interleukins, and calcidiol levels in middle-aged women after a 12-week NW training program. Study Design. In this study, we examined the effects of NW training on selected measures and changes in body weight, fat mass, and calcidiol levels. Methods. The study group consisted of 13 women (46 ± 4.2 years), who took part in trainings. Before and after the training program, some anthropometric indices were determined and selected biochemical parameters were measured in blood. Results. NW training led to a significant decrease of the total body mass and fat mass and to an increase in lean body mass (p<0.05). It also contributed to a significant increase in total antioxidative status (TAS) and calcidiol levels (p<0.05). Before training, a reverse correlation between IL-6 and total oxidative capacity (TOC) levels (p<0.05) was found, while after training between IL-6 and calcidiol levels (p≤0.001). Conclusions. 12-week NW training undertaken by premenopausal women not only has a positive effect on body composition but also on the plasma antioxidative capacity

Ocena stężenia erytromycyny w surowicy krwi z tętnicy pępowinowej

Objectives: The aim of the study was to investigate the effectiveness of erythromycin in preventing intrauterine infection caused by group B streptococcus (GBS). Material and methods: The study included 20 pregnant women with GBS-positive screening or whose laboratory screening was not available, who delivered between April 17, 2013 and July 22, 2013. The women were given 600 mg of erythromycin intravenously. After delivery, blood was drawn in parallel from maternal antecubital vein and umbilical cord artery. Serum erythromycin concentrations were evaluated using enzyme-linked immunosorbent assay (ELISA) kit. Statistical analysis for measurable and non-measurable characteristics were performed, correlation coefficients for each pair of variables were calculated in order to investigate the sought dependence. Results: Mean placental transfer of erythromycin was 2.04%. There was a high correlation between umbilical artery serum and maternal serum erythromycin concentration. Selected variables of mothers in the control group had no effect on serum erythromycin concentration in the umbilical artery. Conclusions: Transplacental transfer of erythromycin is limited (2.04%). Intravenous application of erythromycin at a dose of 600 mg does not allow to achieve the value of MIC50 and MIC90 for erythromycin against strains S. agalactiae in umbilical artery serum, what suggests a compromised efficacy in the treatment of intrauterine fetal infections. At the same time, the placenta seems to be an effective barrier reducing fetal exposure when this macrolide is used to treat maternal infections.Cel: Celem badania była ocena skuteczności erytromycyny w zapobieganiu infekcji wewnątrzmacicznych wywołanych obecnością paciorkowców z grupy B (GBS). Materiał i metody: Badaniem objęto 20 kobiet ciężarnych, z pozytywnym wynikiem badań na nosicielsto GBS lub dla których wyniki badań nie były znane. Porody odbywały się w okresie od 17 kwietnia 2013 roku do 22 lipca 2013 roku. Pacjentkom podawano dożylnie 600 mg erytromycyny. Po porodzie równolegle pobierano próbki krwi z tętnicy pępowinowej oraz od matki z żyły łokciowej. Poziom stężenia erytromycyny oceniano z użyciem testu immunoenzymatycznego (ELISA). Przeprowadzono analizy statystyczne cech mierzalnych i niemierzalnych, obliczono współczynniki korelacji dla poszczególnych par zmiennych w celu zbadania poszukiwanych zależności. Wyniki: Przezłożyskowy transport erytromycyny w badanej grupie wynosił średnio 2,04%. Zaobserwowano wysoką korelację między poziomem stężenia erytromycyny w surowicy krwi matki i w tętnicy pępowinowej. Wybrane zmienne opisujące matkę nie miały wpływu na poziom stężenia erytromycyny w tętnicy pępowinowej. Wnioski: Erytromycyna w ograniczonym stopniu przechodzi przez łożysko (2,04%). Podanie leku w dawce 600 mg nie pozwala na osiagnięcie wartości MIC50 i MIC90 erytromycyny wobec szczepów S. agalactiae w surowicy krwi z tętnicy pępowinowej. Sugeruje to małą skuteczność badanego antybiotyku w leczeniu infekcji wewnątrzmacicznych płodu. Jednocześnie łożysko stanowi skuteczną ochronę płodu, gdy celem jest leczenie infekcji występującej jedynie u matki

The outcome of primary mediastinal B-cell lymphoma in a single center experience

IntroductionPrimary mediastinal B-cell lymphoma (PMBCL) is an aggressive distinct subtype of diffuse large B-cell lymphoma (DLBCL). There is no standard treatment for PMBCL and the value of mediastinal radiotherapy and autologous hematopoietic stem cell transplantation (AHSCT) remains to be elucidated.Material and methodsA retrospective analysis of 12 patients with PMBCL (8 male and 4 female) at median age of 36 years has been performed. Induction chemotherapy consisted of R-DA-EPOCH (n=7), R-CHOP (n=4) and R-CVP (n=1). Second and third line treatments were administered in 6 and 2 patients, respectively. Nine patients were given involved field mediastinal radiotherapy. Finally, 8 patients were proceeded to AHSCT.ResultsFour patients achieved CR and 4 PR after induction therapy with an overall response rate of 66%. In total, after completion all lines of the combined chemotherapy, the following disease responses have been observed: complete response (CR) in 4 patients, partial response (PR) in 6 and no response/disease progression (NR/PD) in 2. The overall response rate was 83%. Eight patients were proceeded to AHSCT (4 in CR and 4 in PR). The transplant-related mortality was 0% at day 100. Median follow-ups from diagnosis and from AHSCT were 39.5 months (range 8–106) and 32 months (range 3–95), respectively. All transplanted patients are alive with CR confirmed in PET scans.ConclusionsThe vast majority of PMBCL patients are susceptible to immunochemotherapy with a high response rate achieved after R-DA-EPOCH/R-CHOP regimens. AHSCT seems to be an option for fit patients with disease chemosensitivity