Long-term prognosis is related to mid-term changes of glucometabolic status in patients with acute myocardial infarction treated invasively

Wstęp: Metabolizm glukozy u pacjentów z zawałem serca (MI) ma znaczenie rokownicze, jednak może zmieniać się po ostrej fazie choroby. Cel: Celem pracy było określenie znaczenia rokowniczego zmian metabolizmu glukozy wykrytych na podstawie doustnego testu obciążenia glukozą wykonanego przy wypisywaniu ze szpitala oraz podczas wizyty kontrolnej u chorych leczonych inwazyjnie w ostrej fazie MI. Metody: Stan metaboliczny określono na podstawie glikemii po 2 godzinach od obciążenia glukozą jako nieprawidłowa tolerancja glukozy lub prawidłowa tolerancja glukozy. Spośród 454 pacjentów, którzy przeżyli okres wewnątrzszpitalny, w wizytach kontrolnych uczestniczyło 368 (81%) chorych, którzy zostali podzieleni na cztery grupy w zależności od stanu metabolicznego określonego przy wypisywaniu ze szpitala i podczas wizyty kontrolnej: grupa 1 — nieprawidłowa tolerancja glukozy przy wypisywaniu ze szpitala i podczas wizyty kontrolnej (n = 101); grupa 2 — nieprawidłowa tolerancja glukozy przy wypisywaniu ze szpitala i prawidłowa podczas wizyty kontrolnej (n = 48); grupa 3 — prawidłowa tolerancja glukozy przy wypisywaniu ze szpitala i nieprawidłowa podczas wizyty kontrolnej (n = 114); grupa 4 — prawidłowa tolerancja glukozy przy wypisywaniu ze szpitala oraz podczas wizyty kontrolnej (n = 105). Śmiertelność całkowita została porównana między grupami przy użyciu testu log-rank. Wyniki: Mediana czasu do wizyty kontrolnej wyniosła 7 miesięcy. Mediana czasu całkowitej obserwacji po MI — 31 miesięcy. Podczas wizyty kontrolnej glikemia po 2 godzinach od obciążenia glukozą była znamiennie wyższa w grupie pacjentów z potwierdzoną nieprawidłową tolerancją glukozy niż w pozostałych grupach badanych. Śmiertelność była wyższa w grupie 1 (11,9%) niż w grupie 2 (2,1%; p = 0,034), jak również w grupie 1 niż w grupie 4 (2,9%; p = 0,009). Rokowanie pacjentów w grupie 2 i w grupie 4 było podobne (2,1% vs. 2,9%; p = 0,781). Śmiertelność w grupie 1 była prawie 2-krotnie wyższa niż w grupie 3 (11,9% vs. 6,1%; p = 0,114), a w grupie 3 ponad 2-krotnie wyższa niż w grupie 4 (6,1% vs. 2,9%; p = 0,247), jednak różnice te nie były istotnie statystycznie. Wnioski: Rokowanie pacjentów, u których podczas wizyty kontrolnej potwierdzono nieprawidłową tolerancję glukozy, było gorsze niż w pozostałych grupach badanych. Pacjenci, u których przy wypisywaniu ze szpitala stwierdzono nieprawidłową tolerancję glukozy, jeżeli poprawili profil metaboliczny, mieli podobne rokowanie do osób z potwierdzoną prawidłową tolerancją glukozy. Otrzymane wyniki mają znaczenie kliniczne, ponieważ wskazują, że ponowna ocena stanu metabolicznego na podstawie doustnego testu obciążenia glukozą u chorych po MI poprawia i wzmacnia stratyfikację ryzyka wykonaną przy wypisywaniu ze szpitala.Background: Glucometabolic status (GS) in patients with acute myocardial infarction (AMI) has an impact on prognosis, but it may change over time. Aim: To evaluate the prognosis after AMI treated invasively with respect to changes in GS assessed by oral glucose tolerance test at discharge and at mid-term follow-up visit (FU-visit). Methods: Glucometabolic status was assessed by two-hour post-load glycaemia and defined as abnormal glucose tolerance (AGT) or normal glucose tolerance (NGT). Out of 454 in-hospital AMI survivors, 368 (81%) patients completed an FU-visit and were divided into four groups with respect to GS at discharge and FU-visit: group 1 — AGT at discharge and FU-visit (n = 101); group 2 — AGT at discharge and NGT at FU-visit (n = 48); group 3 — NGT at discharge and AGT at FU-visit (n = 114); and group 4 — NGT at discharge and FU-visit (n = 105). All-cause mortality was compared between groups with log-rank test. Results: Median time from AMI to FU-visit was seven months. Median remote follow-up duration after AMI was 31 months. Two-hour post load glycaemia was significantly higher in patients with confirmed AGT at FU-visit than in other groups. Mortality was higher in group 1 (11.9%) than in group 2 (2.1%; p = 0.034) and group 4 (2.9%; p = 0.009). Mortality rates between group 2 and 4 were similar (2.1% vs. 2.9%; p = 0.781). There was no significant difference in mortality between group 1 and group 3 (11.9% vs. 6.1%; p = 0.114). Mortality in group 3 was over two-fold higher than in group 4; however, this difference was statistically non-significant (6.1% vs. 2.9%; p = 0.247). Conclusions: Prognosis for patients with confirmed AGT was unfavourable; however, patients with AGT at discharge, in whom GS improved, had similar mortality to subjects with persistent NGT. The major clinical implication from this study is the finding that reassessment of GS by repeated oral glucose tolerance test has significant prognostic value and makes initial risk stratification performed at discharge more reliable

Argumentacja w edukacji: postulaty badań edukacyjnych w polskiej szkole argumentacji

Uwzględniając dotychczasową działalność Polskiej Szkoły Argumentacji, w szczególności jej działalność edukacyjną wyeksponowaną podczas XV konferencji ArgDiaP, sformułowaliśmy postulaty dotyczące dalszej działalności edukacyjnej Szkoły. Ich realizacja w ciągu najbliższych lat mogłaby stanowić grunt dla długoterminowych celów edukacyjnych, takich jak (1) opracowanie spójnego programu nauczania sztuki argumentowania i krytycznego myślenia w szkołach podstawowych i średnich oraz (2) zaprojektowanie ogólnopolskich standardów i ram nauczania przedmiotów powiązanych z argumentacją i krytycznym myśleniem na poziomie studiów uniwersyteckich

Analiza wahadła odwróconego sterowanego elektromagnetycznie

źródłapraca inżyniersk

What Do You Mean When You Say You Like This Painting? Oculomotor Indices of Processes Involved in Aesthetical Appreciation

This study aims to verify the hypotheses concerning emotional and cognitive predictors of aesthetic judgments, operationalized by instructions for viewing paintings from different perspectives (emotions and feelings, empathy, the captured moment, important elements, title, and mystery). Two eye movement parameters: fixation duration average and scan path length, estimated based on data recorded during viewing paintings, were analyzed. The extent to which the parameters of eye movement while performing different instructions predict the same parameters during the aesthetic assessment task was investigated. It was assumed that similar parameters of eye movements are indicators of similar mental processes, activated under different instructions. The viewing time window and expertise of participants were independent variables. Data were analyzed by multilevel modeling. The results showed that at the early stage of viewing a painting, instructions that activate emotional processing (regardless of expertise), better predict the aesthetic evaluation of a painting than instructions activating cognitive processes. At this stage, it was also found that the eye movement parameters, during the performance of instructions that activate cognitive processing, better predict the aesthetic evaluation of paintings only in the group trained in visual arts. At the later stage of viewing paintings, instructions activating cognitive processes turned out to be more reliable predictors of eye movement parameters during the aesthetic evaluation task than instructions activating emotional processes in both groups of participants. The results of the experiment were confronted with the existing models of perception of art and aesthetic experience

Relevance of MicroRNAs as Potential Diagnostic and Prognostic Markers in Colorectal Cancer

Colorectal cancer (CRC) is currently the third and the second most common cancer in men and in women, respectively. Every year, more than one million new CRC cases and more than half a million deaths are reported worldwide. The majority of new cases occur in developed countries. Current screening methods have significant limitations. Therefore, a lot of scientific effort is put into the development of new diagnostic biomarkers of CRC. Currently used prognostic markers are also limited in assessing the effectiveness of CRC therapy. MicroRNAs (miRNAs) are a promising subject of research especially since single miRNA can recognize a variety of different mRNA transcripts. MiRNAs have important roles in epigenetic regulation of basic cellular processes, such as proliferation, apoptosis, differentiation, and migration, and may serve as potential oncogenes or tumor suppressors during cancer development. Indeed, in a large variety of human tumors, including CRC, significant distortions in miRNA expression profiles have been observed. Thus, the use of miRNAs as diagnostic and prognostic biomarkers in cancer, particularly in CRC, appears to be an inevitable consequence of the advancement in oncology and gastroenterology. Here, we review the literature to discuss the potential usefulness of selected miRNAs as diagnostic and prognostic biomarkers in CRC

Systemic Interleukins’ Profile in Early and Advanced Colorectal Cancer

Tumor microenvironment (TME) is characterized by mutual interactions of the tumor, stromal and immune cells. Early and advanced colorectal tumors differ in structure and present altered serum cytokine levels. Mutual crosstalk among TME infiltrating cells may shift the balance into immune suppressive or pro-inflammatory, antitumor response this way influencing patients’ prognosis. Cancer-related inflammation affects all the body and this way, the systemic level of cytokines could reflect TME processes. Despite numerous studies, it is still not known how systemic cytokines levels change during colorectal cancer (CRC) tumor development. Better understanding tumor microenvironment processes could help in planning therapeutic interventions and more accurate patient prognosis. To contribute to the comprehension of these processes within TME, we reviewed cytokines levels from clinical trials in early and advanced colorectal cancer. Presented data were analyzed in the context of experimental studies and studies analyzing tumor infiltration with immune cells. The review summarizes clinical data of cytokines secreted by tumor microenvironment cells: lymphocytes T helper 1 (Th1), lymphocytes T helper 2 (Th2), lymphocytes T helper 17 (Th17), regulatory T cells (Treg cells), regulatory T cells (Breg cells), M1/M2 macrophages, N1/N2 neutrophils, myeloid-derived suppressor cells (MDSC), dendritic cells (DC), innate lymphoid cells (ILC) natural killer (NK) cells and tumor cells

The Predictive Role of Serum Levels of Soluble Cell Adhesion Molecules (sCAMs) in the Therapy of Advanced Breast Cancer—A Single-Centre Study

Background and Objectives: Soluble cell adhesion molecules (sCAMs) play a significant role in the metastatic potential of breast cancer (BC). They might block lymphocytes and promote angiogenesis and migration of cancer cells. We assessed the usefulness of sCAMs in the prognosis and monitoring of the progression of advanced BC. Materials and Methods: We assessed soluble E-selectin, P-selectin, VCAM-1, ICAM-1, EpCAM, IL-6Ra, TNF-R1, and TNF-R2 in 39 women with aBC. Blood samples were obtained at the beginning of the treatment and after 2 months. Results: The median progression-free survival (PFS) was 9 months, and overall survival (OS) was 27 months. The higher levels of sICAM-1 (HR = 2.60, p = 0.06) and lower levels of sEpCAM (HR = 2.72, p < 0.05) were associated with faster progression of aBC. High levels of sEpCAM through the follow-up period were significantly associated with a lower risk of progression (HR = 0.40, p < 0.01). We found the independent predictive value of higher than median sICAM-1 levels for PFS (HR = 2.07, p = 0.08) and of sVCAM-1 levels for OS (HR = 2.59, p < 0.05). Conclusions: Our data support the predictive value of sICAM-1 and sVCAM-1 and suggest that they could become markers for tailoring new therapies in aBC. sEpCAM level could be used as an early indicator of response to the therapy

The influence of elastin degradation products, glucose and atorvastatin on metalloproteinase-1, -2, -9 and tissue inhibitor of metalloproteinases-1, -2, -3 expression in human retinal pigment epithelial cells

Purpose: Hyperglycemia and increased concentrations of elastin degradation products (EDPs) are common findings in patients with diabetes, atherosclerosis and hypertension. The aim of this study was to assess the influence of high glucose, EDPs and atorvastatin on MMP-1, MMP-2, MMP-9 and TIMP1-3 gene expression in human retinal pigment epithelial cells (HRPE) in vitro. Method: HRPE were cultured for 24 hours with the substances being tested (glucose, EDPs), alone or in combination. Additionally, the cells were treated with atorvastatin in two different concentrations (1 or 10 μM). After incubation, total cellular RNA was extracted and used for gene expression evaluation. Gene expression was measured using the real-time RT-PCR technique. Results: Glucose, EDPs and atorvastatin had no impact on TIMP-1 and TIMP-3 expression. HRPE cells treated with glucose or EDPs with the addition of atorvastatin had a statistically significant decrease of TIMP-2 expression; glucose alone decreased MMP-1 expression. Atorvastatin decreased expression of all assessed genes, except TIMP-1 and TIMP-3 in a dose-dependent manner. Conclusions: Our results confirm the importance of MMPs and TIMPs in retinal vascular biology. Atorvastatin-induced MMPs gene expression can deeply affect extracellular matrix turnover, which may play an important role in the progression of ocular diseases

Plasma endothelin-1 in patients with stable or unstable angina

Background: It has been documented that an elevated endothelin-1 (ET-1) plasma concentration is associated with an increased risk of serious coronary events and the presence of angiographically documented coronary artery disease (CAD). The results of a few studies which examined ET-1 plasma level in patients with stable or unstable angina, were inconclusive.Aim: To assess whether ET-1 blood concentration measured in the coronary sinus and peripheral vein is associated with clinical symptoms in patients with multi-vessel CAD.Methods: The study group consisted of 23 patients with multi-vessel CAD of whom 11 had unstable angina and 12 - stable angina. Both groups were matched with regard to age, gender and the presence of cardio-vascular risk factors. Blood samples for ET-1 assessment were taken during coronary angiography simultaneously from the coronary sinus and femoral vein. ET-1 was measured using an immunoenzymatic method.Results: ET-1 plasma level in the peripheral venous circultion was similar in patients with unstable or stable angina (0.45±0.18 pmol/L versus 0.46±0.14 pmol/L, NS) whereas ET-1 level in the coronary sinus was significantly higher in patients with unstable angina (1.44±0.47 pmol/L versus 0.34±0.17 pmol/L,