Prognostic significance of red cell distribution width and its relation to increased pulmonary pressure and inflammation in acute heart failure

Background: Red cell distribution width (RDW) in acute heart failure (AHF) is accepted as a prognostic indicator with unclear pathophysiological ties. The aim of this study was to evaluate the prognostic value of RDW in AHF patients in relation to clinical and echocardiographic data.Methods: 170 patients with AHF were retrospectively studied. All patients had laboratory testing and an echocardiogram performed within 24 h of admission to the Cardiology Department. Results: During the mean 193 ± 111 days of follow-up, 33 patients died. More advanced age, high RDW and low peak early diastolic velocity of the lateral mitral annulus (MVe’) were independent predictors of all-cause mortality with hazard ratios of: 1.05 (95% CI 1.02–1.09), p < 0.005, 1.40 (95% CI 1.22–1.60), p < 0.001, and 0.77 (95% CI 0.63–0.93), p < 0.007, respectively. In a stepwise multiple linear regression model, RDW was correlated with hemoglobin concentration (standardized b = –0.233, p < 0.001), mean corpuscular volum (standardized b = –0.230, p < 0.001), mean corpuscular hemoglobin concentration (standardized b = –0.207, p < 0.007), the natural logarithm of C-reactive protein (CRP) (standardized b = 0.184, p < 0.004) and tricuspid regurgitation peak gradient (TRPG) values (standardized b = 0.179, p < 0.006), whereas MVe’ was correlated with atrial fibrillation (standardized b = 0.269, p < 0.001).Conclusions: The present data demonstrates a novel relation between higher levels of RDW and elevatedTRPG and high sensitivity CRP values in patients with AHF. These findings suggest that RDW, the most important mortality predictor, is independently associated with elevated pulmonary pressure and systemicinflammation in patients with AHF. Moreover, in AHF patients, more advanced age and decreased MVe’ are also independently associated with total mortality risk

Identification of clinical risk factors of atrial fibrillation in congestive heart failure

Background: Factors associated with the development of atrial fibrillation (AF) in generalpopulation have been described, but it is still unknown whether the same risk factors applyto heart failure (HF) patients. The aim of this study was to identify clinical factors related tovarious forms of AF in HF patients.Methods: The clinical and echocardiographic characteristics were assessed in 155 HF patients:50 with sinus rhythm, 52 with non-permanent AF, and 53 with permanent AF.Results: Multivariate logistic regression analysis showed that the increase in the NYHAclass was an independent risk factor for both forms of AF. The occurrence of permanent AF incomparison to sinus rhythm group was independently associated with hs-C-reactive protein(CRP) elevation above 1 mg/dL (OR 1.87, 95% CI 1.05–3.35), left atrial dimension above4 cm (OR 3.78, 95% CI 1.29–11.06) and tricuspid maximal pressure gradient elevation above35 mm Hg (OR 5.01, 95% CI 1.38–18.27). The presence of coronary disease was independentlyassociated with less frequent occurrence of permanent AF in comparison to sinus rhythm group(OR 0.21, 95% CI 0.06–0.67).Conclusions: More advanced congestive HF was associated with presence of both types of AF.Non-ischemic etiology of HF and elevated CRP are independently associated with permanentAF compared to sinus rhythm. Left ventricular diastolic dysfunction indicators (increasedtricuspid maximal pressure gradient and left artial dimension) are independently associatedwith permanent AF

Application of Volatile Compounds Analysis for Distinguishing between Red Wines from Poland and from Other European Countries

Authenticity and the geographical origin of wines are terms of great importance for consumers and producers. This work is focused on distinguishing between red wines from Poland and from other European countries, notably France, Italy and Spain. To achieve this goal, we determined aroma compounds in wines from different countries by headspace solid-phase microextraction/gas chromatography-mass spectrometry. The content of hexan-1-ol in Polish wines was significantly higher (about twice as high) than in French, Italian and Spanish wines.  Linear discriminant analysis (LDA) showed that 3-(methylsulfanyl) propane-1-ol, hexan-1-ol, ethyl phenylacetate and ethyl 2-hydroxy-4-methylpentanoate were the most discriminant variables for distinguishing between wines from Poland and from other European countries.  Hierarchical cluster analysis (HCA) revealed that Polish wines were separated thoroughly from the other wines based on ethyl phenylacetate, hexan-1-ol, ethyl 2-hydroxy-4-methylpentanoate, (E)-3-hexen-1-ol, 2-phenylethanol and 3-(methylsulfanyl)propan-1-ol, which is important for preventing possible frauds

Alert mobilisation of the 1st Infantry Division (Legion) in August 1939

The 1st Infantry Division (Legion) of Józef Piłsudski was generally acknowledged as an elite unit. It was also the only division in the Polish Army whose all regiments, including the light artillery regiment, were decorated with the Virtuti Militari Cross for their engagement in the Polish-Soviet War.In the mobilisation plan “W”, the division was included in the so called coloured units, intended for alert mobilisation in the card system. The beginning of mobilization in the Vilnius garrison, like in all other units subject to alert mobilization, took place at dawn on August 24, 1939. The supplementation of the garrison’s personnel to the war etatings took place smoothly and without any major difficulties. The relations emphasise the excellent attendance of the reservists. The mobilisation of a sufficient number, and above all quality, of horses and horse-drawn vehicles and the appropriate equipping of all soldiers proved to be a huge problem.The division’s mobilisation, despite some difficulties, generally proceeded as scheduled. Its symbolic end was the parade that took place on the evening of 27 August in front of the mausoleum on Rossa – it was a symbolic farewell to the Marshal, whose name the division bore. The next day, in the evening, the transport of the unit to the area of the planned concentration began.1 Dywizję Piechoty Legionów (1 DP Leg.) Józefa Piłsudskiego, jedyną w Wojsku Polskim, powszechnie uważano za jednostkę elitarną. Jej pułki, łącznie z pułkiem artylerii lekkiej, odznaczono Orderem Wojennym Virtuti Militari za udział w wojnie polsko-bolszewickiej.W planie mobilizacji „W” 1 DP Leg. wchodziła w skład tzw. jednostek kolorowych, przewidzianych do mobilizacji alarmowej w systemie kartkowym. Początek mobilizacji w garnizonie wileńskim, podobnie jak we wszystkich pozostałych objętych mobilizacją alarmową, nastąpił o świcie 24 sierpnia 1939 r. Uzupełnienie stanów osobowych jednostek do etatów wojennych odbyło się sprawnie i bez większych trudności. W relacjach podkreśla się wzorowe stawiennictwo rezerwistów. Ogromnym problemem okazało się zdobycie odpowiedniej liczby koni, a przede wszystkim dobrej jakości wozów taborowych oraz należyte wyposażenie wszystkich żołnierzy.Mobilizacja dywizji, pomimo pewnych trudności, przebiegała jednak na ogół zgodnie z harmonogramem. Jej symbolicznym zakończeniem była defilada, która odbyła się wieczorem 27 sierpnia 1939 r. przed mauzoleum Piłsudskiego na Rossie w Wilnie – było to symboliczne pożegnanie z Marszałkiem, patronem dywizji. Następnego dnia wieczorem rozpoczął się transport jednostki do rejonu planowanej koncentracji

Biomarkery raka stercza

Prostate cancer is the second most common cancer in men in Poland. Biomarkers are helpful in diagnosing of this neoplasm. The most popular and the best known biomarker in detecting of prostate cancer is PSA which serves as the essential diagnostic tool combined with digital rectal examination. Total PSA, free PSA, proPSA and fluctuations intPSA levels in time can be measured. In patients with the established diagnosis of prostatic cancer circulating tumour, cells (CTCs) can be counted. Their concentration is increased in metastatic prostate cancer. CTCs level superior to 5/7.5 ml is associated with poor survival. Molecular phenotyping of CTCs is useful in predicting drug sensitivity and in choosing the best individual therapeutic approach. Besides blood serum investigations there are also urinary and cellular (including genetic) biomarkers. To increase the accuracy of monitoring the treatment of the cancer, multiple biomarker panels are created e.g. PSA, CTCs, albumins and LDH.Rak stercza jest drugim co do częstości nowotworem złośliwym u mężczyzn w Polsce. W diagnostyce tego nowotworu pomocne jest wykorzystanie różnych biomarkerów. Najbardziej popularnym i najlepiej poznanym wskaźnikiem jest PSA, który obok per rectum stanowi podstawowe badanie przesiewowe. Ocenie i interpretacji podlega stężenie całkowite PSA, stężenie frakcji wolnej oraz subfrakcji proPSA, a także zmiany stężenia PSA w czasie. U chorych ze zdiagnozowanym rakiem gruczołu krokowego wielu cennych informacji dostarcza analiza liczby krążących komórek nowotworowych (CTC). Ich stężenie rośnie w przypadku pojawienia się przerzutów. Wartość przekraczająca 5 CTC/7,5 ml krwi obwodowej wiąże się z niższą medianą przeżycia. Ponadto wyznaczenie profilu ekspresji genów CTC pozwala na przewidywanie lekowrażliwości komórek rakowych i indywidualny dobór terapii przeciwnowotworowej. Poza markerami osoczowymi wykorzystuje się również markery w moczu (m.in. PCA3) oraz markery komórkowe. Projektowane są pakiety łączące różne markery (np. PSA, CTC, albuminy i PSA), aby zwiększyć precyzję monitorowania przebiegu choroby i efektywność leczenia

On the flow map for 2D Euler equations with unbounded vorticity

In Part I, we construct a class of examples of initial velocities for which the unique solution to the Euler equations in the plane has an associated flow map that lies in no Holder space of positive exponent for any positive time. In Part II, we explore inverse problems that arise in attempting to construct an example of an initial velocity producing an arbitrarily poor modulus of continuity of the flow map.Comment: http://iopscience.iop.org/0951-7715/24/9/013/ for published versio

The influence of acute pulmonary embolism on early and delayed prognosis for patients with chronic heart failure

Background: Patients with acute pulmonary embolism (APE) with concomitant chronic heart failure (CHF) are characterized by higher mortality rates than APE patients without CHF. The aim of this study is to evaluate the potential impact of APE on early and long-term prognosis in patients with CHF. Methods: This study included 87 patients with CHF with suspected APE. Patients were divided into two groups according to spiral computed tomography results: one group with confirmed APE and one with excluded APE. Total and cardiovascular mortality in patients of both groups during a 6- and 36-month follow up period was assessed. Potential risk factors for mortality in patients with CHF in short and long-term observations were identified. Results: APE was diagnosed in 35 patients, and excluded in the remaining 52 patients. Total and cardiovascular 6-month mortality was higher in APE patients than in patients without APE: 34.3% and 28.5% vs. 13.4% and 11.5%, p = 0.02, p = 0.02, respectively. In 6-month follow-up the only independent risk factor for mortality was the presence of APE (HR = 2.7, 95% CI 1.1–24.4, p = 0.04). However, in the 36-month follow-up APE had no effect on mortality. Conclusions: Patients with CHF and acute episode of PE are characterized by a higher 6-month total and cardiovascular mortality rate following discharge from hospital compared to patients hospitalized due to acute CHF decompensation. Moreover, recent episode of PE in patients with CHF is an independent risk factor for early mortality in a 6-month follow-up

Mast cell derived carboxypeptidase A3 is decreased among patients with advanced coronary artery disease

Background: Coronary artery disease (CAD) affects milions of people and can result in myocardialinfarction (MI). Previously, mast cells (MC) have been extensively investigated in the context of hypersensitivity,however as regulators of the local inflammatory response they can potentially contribute toCAD and/or its progression. The aim of the study was to assess if serum concentration of MC proteases:carboxypeptidase A3, cathepsin G and chymase 1 is associated with the extension of CAD and MI.Methods: The 44 patients with angiographically confirmed CAD (23 subjects with non-ST-segmentelevation MI [NSTEMI] and 21 with stable CAD) were analyzed. Clinical data were obtained as wellserum concentrations of carboxypeptidase A3, cathepsin G and chymase 1 were also measured.Results: Patients with single vessel CAD had higher serum concentration of carboxypeptidase thanthose with more advanced CAD (3838.6 ± 1083.1 pg/mL vs. 2715.6 ± 442.5 pg/mL; p = 0.02). Therewere no significant differences in levels of any protease between patients with stable CAD and those withNSTEMI. Patients with hypertension had ≈2-fold lower serum levels of cathepsin G than normotensiveindividuals (4.6 ± 0.9 pg/mL vs. 9.4 ± 5.8 pg/mL; p = 0.001). Cathepsin G levels were also decreasedin sera of the current smokers as compared with non-smokers (3.1 ± 1.2 ng/mL vs. 5.8 ± 1.2 ng/mL,p = 0.02).Conclusions: Decreased serum level of carboxypeptidase is a hallmark of more advanced CAD. Lowerserum levels of carboxypeptidase A3 and catepsin G are associated with risk factors of blood vessel damagesuggesting a protective role of these enzymes in CAD

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) — clinical features, diagnosis, and treatment in the experience from a single institution

Wstęp. Nowotwór z blastycznych plazmocytoidnych komórek dendrytycznych (BPDCN) jest rzadko rozpoznawaną i bardzo źle rokującą chorobą rozrostową wywodzącą się z prekursorów plazmocytoidnych komórek dendrytycznych. W pracy opisano doświadczenia Kliniki Nowotworów Układu Chłonnego Centrum Onkologii — Instytutu w Warszawie wynikające z leczenia chorych w latach 2006–2012, u których stwierdzono tę rzadką jednostkę chorobową.Materiał i metody. Grupa chorych liczyła 7 osób, w tym 4 mężczyzn. Mediana wieku chorych to 68 lat (37–78 lat). Objawem podstawowym były u wszystkich zmiany skórne, ale stwierdzano też wtórne zajęcie węzłów chłonnych (n = 3), krwi obwodowej (n = 1) i szpiku (n = 3). Chorobę rozpoznano na podstawie charakterystycznego obrazu immunofenotypowego w badaniu histopatologicznym i cytometrycznym uzyskanym ze skóry, krwi obwodowej oraz szpiku (CD 4+/CD56+: n = 7, CD 123+: n = 3).Wyniki. U 3 chorych początkowo błędnie rozpoznano czerniaka w innych ośrodkach diagnostycznych. Trzech chorych otrzymało chemioterapię stosowaną w przypadkach chłoniaków nie-Hodgkina, u 3 zastosowano programy przewidziane dla ostrej białaczki szpikowej. Jeden chory otrzymał chemioterapię stosowaną w ostrej białaczce limfoblastycznej, a następnie został poddany allotransplantacji komórek krwiotwórczych od dawcy rodzinnego, pozostaje w całkowitej remisji, a jego czas przeżycia wynosi 80 miesięcy. Mediana całkowitego przeżycia pozostałych 6 chorych niepoddanych przeszczepieniu wyniosła 3,5 miesiąca (1,5–20 miesięcy).Wnioski. Zróżnicowany obraz kliniczny utrudnia rozpoznanie tej jednostki chorobowej, a optymalny sposób leczenia nie jest ustalony i wymaga dalszych badań. Zwraca uwagę dobry wynik leczenia pacjenta poddanego alloprzeszczepieniu komórek krwiotwórczych.Introduction. Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is rarely diagnosed proliferative disease with very poor prognosis originating from the precursors of plasmacytoid dendritic cells.Materials and methods. In this study, we report on 7 patients diagnosed and treated at our institution between 2006 and 2012. Median age of patients was 68 years (range 37–78 years), and 4 were men. All patients presented with a skin lesion, with additional secondary lymph nodes (n = 3), peripheral blood (n = 1) and bone marrow involvement (n = 3). Disease was diagnosed based on typical immunophenotypical features in histopathological and flow cytometry examination of skin, blood or bone marrow (CD 4+/CD56+: n = 7, CD 123+: n = 3).Results. Three patients were initially diagnosed with melanoma. Three of patients were treated with non-Hodgkin lymphoma-directed chemotherapy, three other — acute myeloid leukemia chemotherapy and one with acute lymphoblastic leukemia-type treatment. Median overall survival of non transplanted patients (n = 6) was 3.5 months (range 1.5–20 months), while patient allografted from related donor, treated with acute lymphoblastic leukemia-type chemotherapy, remains in complete remission until now (OS = 80 months).Conclusion. This rare entity is a diagnostic challenge and needs dedicated clinical studies to establish appropriate therapy. Of note is a good outcome of a single patient after allogeneic stem cell transplantation