Retrograde diastolic blood flow in the aortic isthmus is not a simple marker of abnormal fetal outcome in pregnancy complicated by IUGR – a pilot study

Aim: To evaluate the relation between retrograde diastolic blood flow in the aortic isthmus and adverse perinatal outcome in fetuses with IUGR. Materials and Methods: The study included 33 fetuses with IUGR defined as the estimated fetal weight and abdominal circumference under the 10th percentile for a given gestational age. The Doppler examination of the blood flow in the aortic isthmus, umbilical artery, umbilical vein, middle cerebral artery, uterine arteries and ductus venosus was performed regularly. The study population was further divided into two subgroups, depending on the aortic isthmus blood flow direction, i.e. with and without retrograde isthmic diastolic flow. Furthermore, the relation between Doppler blood flow parameters and determinants of the perinatal outcome was analyzed. The perinatal outcome was reported as adverse if any of the following occurred: umbilical cord blood pH < 7,2; 5-minute Apgar score < 7; respiratory distress syndrome, intraventricular hemorrhage (III/IV grade); necrotizing enterocolitis; sepsis; intrauterine or neonatal death. Results: There was no statistically significant difference in the incidence of adverse perinatal outcome between the antegrade and retrograde isthmic blood flow groups. Moreover, the study showed no statistically significant relationship between the retrograde blood flow in the aortic isthmus and the prevalence of abnormal flow in the analyzed vessels. Conclusion: Retrograde diastolic blood flow in the aortic isthmus presents a low sensitivity and low predictive value in predicting the adverse perinatal outcome in pregnancies complicated with IUGR

Protein and folic acid content in the maternal diet determine lipid metabolism and response to high-fat feeding in rat progeny in an age-dependent manner

Maternal diet during gestation can exert a long-term effect on the progeny’s health by programming their developmental scheme and metabolism. The aim of this study is to analyze the influence of maternal diet on lipid metabolism in 10- and 16-week-old rats. Pregnant dams were fed one of four diets: a normal protein and normal folic acid diet (NP-NF), a protein-restricted and normal folic acid diet (PR-NF), a protein-restricted and folic-acid-supplemented diet (PR-FS), or a normal protein and folic-acid-supplemented diet (NP-FS). We also tested whether prenatal nutrition determines the reaction of an organism to a postweaning high-fat diet. Blood biochemistry and biometrical parameters were evaluated. The expression patterns of PPARα, PPARγ, and LXRα in the liver and adipose tissue were examined by real-time PCR. In the 10-week-old, rats folic acid supplementation of the maternal diet was associated with reduced circulating glucose and total cholesterol concentrations (P < 0.01 and P < 0.001, respectively). Neither prenatal diets nor postnatal feeding affected blood insulin concentrations. In the 16-week-old rats, body weight, abdominal fat mass and central adiposity were reduced in the progeny of the folic acid–supplemented dams (P < 0.01, P < 0.001 and P < 0.01, respectively). Maternal protein restriction had no effect on biometry or blood biochemical parameters. Folic acid supplementation of the maternal diet was associated with reduced expression of PPARα, PPARγ, and LXRα in the liver (P < 0.001). Reduced protein content in the maternal diet was associated with increased PPARα mRNA level in the liver (P < 0.001) and reduced LXRα in adipose tissue (P < 0.01). PPARα and PPARγ transcription in the liver, as well as LXRα transcription in adipose tissue, was also dependent on interaction effects between prenatal and postnatal diet compositions. PPARγ transcription in the liver was correlated with the abdominal fat mass, body weight, and calorie intake, while PPARγ transcription in adipose tissue was correlated with reduced body weight and calorie intake. Total serum cholesterol concentration was correlated with LXRα transcription in the liver. Folic acid supplementation of the maternal diet may have favorable effects for lipid metabolism in the progeny, but these effects are modified by the postnatal diet and age. Furthermore, the expression of LXRα, PPARα, and PPARγ in the liver and adipose tissue largely depends on the protein and folic acid content in the maternal diet during gestation. However, the altered transcription profile of these key regulators of lipid metabolism does not straightforwardly explain the observed phenotype

The role of a nurse in the education of a person suffering from diabetes type 1 and their family

Cukrzyca typu 1 to jedna z najczęstszych przewlekłych chorób wieku dziecięcego. Jest przyczyną niewydolności nerek, ślepoty, chorób układu sercowo-naczyniowego i przedwczesnej śmierci w populacji ogólnej. Leczenie cukrzycy typu 1 to złożony proces. Jedną z najistotniejszych metod terapii jest edukacja zdrowotna. W pracy przedstawiono działania edukacyjne pielęgniarki wobec dziecka chorego na cukrzycę i jego rodziny. Omówiono etapy edukacji terapeutycznej, czynniki wpływające na przebieg edukacji oraz zagadnienia poruszane w jej trakcie. Zwrócono uwagę na szczególny rodzaj procesu dydaktycznego, jakim jest szkolenie pacjenta przygotowywanego do terapii z zastosowaniem osobistej pompy insulinowej.Type 1 diabetes is one of the most frequent chronic juvenile diseases. It may lead to kidney damage, blindness, cardiovascular diseases and premature death in the general population. The treatment of type 1 diabetes is a complex process. One of the most fundamental methods of therapy is health education. The thesis presents the educational activities of a nurse towards a child suffering from diabetes and their family. It discusses the stages of therapeutic education, the factors affecting the course of education and the issues raised in the process of education. It direct attention to the special kind of education, namely the training of a patient getting ready for the therapy with the use of a personal insulin pump

Molecular evolution of enolase �

Enolase (EC 4.2.1.11) is an enzyme of the glycolytic pathway catalyzing the dehydratation reaction of 2-phosphoglycerate. In vertebrates the enzyme exists in three isoforms: α, β and γ. The amino-acid and nucleotide sequences deposited in the GenBank and SwissProt databases were subjected to analysis using the following bioinformatic programs: ClustalX, GeneDoc, MEGA2 and S.I.F.T. (sort intolerant from tolerant). Phylogenetic trees of enolases created with the use of the MEGA2 program show evolutionary relationships and functional diversity of the three isoforms of enolase in vertebrates. On the basis of calculations and the phylogenetic trees it can be concluded that vertebrate enolase has evolved according to the “birth and death ” model of evolution. An analysis of amino acid sequences of enolases: non-neuronal (NNE), neuron specific (NSE) and muscle specific (MSE) using the S.I.F.T. program indicated non-uniform number of possible substitutions. Tolerated substitutions occur most frequently in α-enolase, while the lowest number of substitutions has accumulated in γ-enolase, which may suggest that it is the most recently evolved isoenzyme of enolase in vertebrates

Evaluation of comprehensive spa treatment of osteoarthritis of the knee at the “Włókniarz” Sanatorium in Busko-Zdrój

Aim of the research : Evaluation studies have been carried out of the effectiveness of rehabilitation procedures with balneotherapy in osteoarthritis of the knee (OAK). Material and methods: Sulphide and hydrogen-sulphide salt waters, and kinesitherapy and chosen physiotherapy methods were used in treatment. Sixty-five people with osteoarthritis of the knee, with an average period of 20 years of duration of the disease, took part in the studies. These patients were divided into two groups. In the first group, baths in sulphide and hydrogen-sulphide salt waters with physiotherapy treatment were used. In the second group, analogous physiotherapy treatment was used, however, due to medical contraindications, sulphide baths were not used. Results : In both groups, a significant improvement of knee joint functions, alleviation of pain and improvement of endurance and aesthetics of walking were observed. Slightly better effects were observed in patients using baths in sulphide and hydrogen-sulphide salt waters. Conclusions: In view of the achieved improvement of the clinical state in patients with OAK, this form of comprehensive sanatorium rehabilitation is recommendable