The prevalence of primary aldosteronism (PA) in a group of 350 hypertensive patients

Background Hypertension is one of the commonest diseases worldwide. Its prevalence is estimated to approximately 25% of the population. In addition, hypertension is an important risk factor for increased cardiovascular events. In most cases it is of idiopathic origin, but may also be due to another disease, e.g. endocrine dysfunction. Primary aldosteronism (PA) is a common cause of resistant hypertension; its proper diagnosis determines further therapy.The aim of this study was to evaluate the prevalence of PA in a group of 350 patients (240 women and 110 men) with hypertension.Material and methods All patients underwent hormonal tests including assessment of the levels of: ACTH, cortisol (baseline and in dexamethasone suppression test), DHEA-S, chromogranin A, VMA urine excretion, aldosterone and active renin. Afterwards, an intravenous load test with 0.9% neutral saline solution was performed. Abdominal ultrasound was performed in all patients, and abdominal computed tomography only in patients with abnormal hormonal tests. Other forms of secondary hypertension were previously excluded.Results Primary aldosteronism was diagnosed in 58 patients (16.6%) — 38 women and 20 men. Adrenal adenoma was found in 20 patients (34.5%), and idiopathic hyperaldosteronism in 38 patients (65.5%). Hypokalaemia occurred in 25 patients (43.1%). Moreover, it was found that the aldosterone-renin ratio above 8.25 supports the diagnosis of PA.Conclusion We conclude that the diagnosis of PA should not be limited only to the hypertensive patient with hypokalaemia. PA is an important cause of hypertension, especially among patients with difficulties in normalization of blood pressure with standard pharmacological treatment.Background Hypertension is one of the commonest diseases worldwide. Its prevalence is estimated to approximately 25% of the population. In addition, hypertension is an important risk factor for increased cardiovascular events. In most cases it is of idiopathic origin, but may also be due to another disease, e.g. endocrine dysfunction. Primary aldosteronism (PA) is a common cause of resistant hypertension; its proper diagnosis determines further therapy.The aim of this study was to evaluate the prevalence of PA in a group of 350 patients (240 women and 110 men) with hypertension.Material and methods All patients underwent hormonal tests including assessment of the levels of: ACTH, cortisol (baseline and in dexamethasone suppression test), DHEA-S, chromogranin A, VMA urine excretion, aldosterone and active renin. Afterwards, an intravenous load test with 0.9% neutral saline solution was performed. Abdominal ultrasound was performed in all patients, and abdominal computed tomography only in patients with abnormal hormonal tests. Other forms of secondary hypertension were previously excluded.Results Primary aldosteronism was diagnosed in 58 patients (16.6%) — 38 women and 20 men. Adrenal adenoma was found in 20 patients (34.5%), and idiopathic hyperaldosteronism in 38 patients (65.5%). Hypokalaemia occurred in 25 patients (43.1%). Moreover, it was found that the aldosterone-renin ratio above 8.25 supports the diagnosis of PA.Conclusion We conclude that the diagnosis of PA should not be limited only to the hypertensive patient with hypokalaemia. PA is an important cause of hypertension, especially among patients with difficulties in normalization of blood pressure with standard pharmacological treatment

Oxidative stress in erythrocytes from patients with rheumatoid arthritis

Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic inflammation. It has been suggested that the level of reactive oxygen species (ROS) in patients with RA is higher than in healthy subjects. The aim of the present study was to investigate the level of the lipid peroxidation, antioxidant enzyme activities (CAT, SOD, GSH-Px), level of the –SH groups and GSH and Na+K+ ATPase activity in erythrocytes from patients with RA. There are no significant differences in CAT and GSH-Px activities. SOD activity is lower in RA patients than in the control group. Increase in the lipid peroxidation is observed in RA patients. Levels of the GHS and –SH groups are significantly lower in RA patients than in the control groups. Total ATPase and Na+K+ ATPase activities decrease in RA patients

The prevalence of high blood pressure as one of cardiovascular risk factors among women with polycystic ovary syndrome

Background Polycystic ovary syndrome (PCOS) is one of the commonest endocrinopathy diagnosed among women mainly at reproductive age. For the first time it was described by Stein and Leventhal in 1935 and defined by two of the three findings: irregular menses (oligo-/amenorrhoea), hyperandrogenism or polycystic ovaries appearance on ultrasound, provided that other causes of androgen excess and dysovulation are excluded. PCOS is very often associated with infertility, endometrium cancer, obesity, insulin resistance, impaired glucose metabolism, higher risk for type 2 diabetes, high blood pressure, impaired lipid profile, mental illnesses and non-alcoholic liver steatosis. The presence of some of mentioned conditions may exacerbate the risk of cardiovascular events in women with PCOS [1, 2].The main goal of our study was to assess the frequency of hypertension among women with PCOS.Material and methods Retrospective analysis of medical records of 213 women, age 17–42 (mean 25 ± 6 years).Results Twenty-two women (10%) in examined group suffered from hypertension. The incidence of elevated blood pressure was higher among women with insulin resistance (p = 0.006). Prevalence odds ratio (OR) of arterial hypertension in the group with hyperprolactinaemia was 0.15 (confidence interval [CI] 0.06–0.37) and in the group with insulin resistance (OR) 1.05 (CI 0.61–1.83).Conclusion The prevalence of hypertension among women with PCOS is higher when compared with healthy women at the same age. Thus, due to the young age of enrolled patients, it seems reasonable to recommend extension of the diagnostics of PCOS with blood pressure assessment.Background Polycystic ovary syndrome (PCOS) is one of the commonest endocrinopathy diagnosed among women mainly at reproductive age. For the first time it was described by Stein and Leventhal in 1935 and defined by two of the three findings: irregular menses (oligo-/amenorrhoea), hyperandrogenism or polycystic ovaries appearance on ultrasound, provided that other causes of androgen excess and dysovulation are excluded. PCOS is very often associated with infertility, endometrium cancer, obesity, insulin resistance, impaired glucose metabolism, higher risk for type 2 diabetes, high blood pressure, impaired lipid profile, mental illnesses and non-alcoholic liver steatosis. The presence of some of mentioned conditions may exacerbate the risk of cardiovascular events in women with PCOS [1, 2].The main goal of our study was to assess the frequency of hypertension among women with PCOS.Material and methods Retrospective analysis of medical records of 213 women, age 17–42 (mean 25 ± 6 years).Results Twenty-two women (10%) in examined group suffered from hypertension. The incidence of elevated blood pressure was higher among women with insulin resistance (p = 0.006). Prevalence odds ratio (OR) of arterial hypertension in the group with hyperprolactinaemia was 0.15 (confidence interval [CI] 0.06–0.37) and in the group with insulin resistance (OR) 1.05 (CI 0.61–1.83).Conclusion The prevalence of hypertension among women with PCOS is higher when compared with healthy women at the same age. Thus, due to the young age of enrolled patients, it seems reasonable to recommend extension of the diagnostics of PCOS with blood pressure assessment

Automatic calculation of thresholds for load dependent condition indicators by modelling of probability distribution functions – maintenance of gearboxes used in mining conveying system

Limit values for gearbox vibration-based condition indicators are key to determine in order to be able to estimate moment when object is in a need of maintenance. Further decision making process usually might utilize simple if-then-else rule using established threshold values. If diagnostic data takes the values from the Gaussian distribution, finding the decision boundaries is not difficult. Simplistically, that comes down to standard pattern recognition technique for “good condition” and “bad condition” based on probability density functions (PDFs) of diagnostic data. This situation is becoming more and more complicated when distribution is not Gaussian. Such cases require to develop much more advanced analytically solution. In this paper, we present the case of belt conveyor’s gearbox for which PDFs of diagnostic features overlap each other because of strong influence of time varying operating conditions on spectral features. New approach to automatic threshold recognition has been proposed based on modeling diagnostic features with Weibull distribution and using agglomerative clustering to distinguish classes of technical condition, which leads to determination of thresholds separating them

How has the treatment of hypercholesterolemia in Poland changed over the last six years?

Background: To assess changes in the treatment of hypercholesterolemia in Polish ambulatory care over the last 6 years. Methods: Data were obtained from two separate questionnaire-based studies, conducted in 2009 and 2015. The analysis included only those patient visits, which were associated with modifications of previous hypercholesterolemia treatment (1924 visits from the year 2009 and 1888 visits from the year 2015). Results: In the present registry, there was a 19 mg/dL reduction in the level of total cholesterol and a 17 mg/dL reduction in the level of low-density lipoprotein compared to year 2009. In both registries, the most common reason for treatment modification was failure to achieve therapeutic goals. Compared to year 2009, there was an increase in the proportion of patients treated with atorvastatin and a reduction in the proportion of patients treated with simvastatin at baseline; additionally, in year 2015, 10% of patients received rosuvastatin. After therapy modification, there was a similar increase in the proportion of patients treated with a statin-fibrate combination in both registries. However, at present, ezetimibe was significantly less often added to previous therapy. In both registries, therapy modification led to an increase in the mean doses of the most commonly used statins, although presently, this increase was smaller than in 2009. Conclusions: The most favorable change in the treatment of hypercholesterolemia is an increase in the proportion of patients treated with strong statins. Unfavorable changes include a reduction in the frequency of polytherapy, especially with ezetimibe, and a tendency to prescribe lower, ineffective statin doses

Complementary feeding with traditional and baby led weaning (BLW) methods - assessment of selected aspects of infant's diet

Background: Infant nutrition is a topic of constant debate between parents and doctors. The recommendations themselves have been modified several times over the past 6 decades. Baby Led Weaning (BLW) method is gaining more and more popularity in infant nutrition during the period of expanding the infant menu. The main aim of the study was to evaluate selected aspects of dietary expansion in a group of their children, taking into account dietary expansion with the use of the traditional method and the BLW method. Material and method: An exploratory cross-sectional study was conducted in December 2021-January 2022 among a randomly selected sample of 523 mothers of children in infancy aged up to 12 months. Data for the study were collected anonymously using the CAWI method. The information collected from 500 women was considered for the final data analysis taking into account the inclusion and exclusion criteria. Results: 66.6% of the women surveyed (N=333) stated that their child is or was fed breast milk during the first six months. The child's diet was most often expanded with complementary meals after 6 months of age. This answer was indicated by 58.8% of respondents (N=294). 85.6% of the surveyed women (N=428) first introduced or intend to introduce vegetables to their diet. 13% of the respondents (N=65) introduced or planned to introduce vegetables and fruit at the same time. In the studied group of mothers the BLW method was not known or not used by 7 mothers (1.4%), 343 mothers used or intended to use the BLW method (68.6%), whereas 150 women knew the BLW method (30.0%), but did not use it or did not intend to use it during the expansion of their child's diet. Conclusions: The majority of mothers surveyed used the BLW method during the expansion of their children's diet, accepting the principle that it is the child who decides whether and how much to eat, and the parent who decides what and when the child eats

Nadmierne korzystanie z sieci społecznościowych

AbstractSocial networking sites (SNS) have become an integral part of people's lives, especially the young. In Poland, the most popular SNS is Facebook – almost 14 million use it every day. Users might communicate by SNS with their friends, share photos and movies or participate in groups. There are many functions of SNS that make them attractive. SNS satisfy their users’ needs such as the need to connect or to self-present. However it is not easy to find one reason why people use SNS. Because of the popularity of this media, a new question arises: it is possible to become addicted to SNS? Scientist use terms such as: excessive use, problem use or even an addiction, but there are still no precise criteria that might be useful to identify this problem. One might find analyses of time spending on SNS and activities performed by users in scientific articles about excessive SNS use. SNS addictive tendency was usually measured by questionnaires based on some internet addiction scales. Future research in this area is needed because SNS are still a novelty and it is necessary to differentiate normal usage from the abnormal.StreszczenieSieci społecznościowe (SNS – Social Networking Sites) stały się integralną częścią życia ludzi, w szczególności osób młodych. W Polsce najpopularniejszą siecią społecznościową jest Facebook – prawie 14 milionów ludzi codziennie z niego korzysta. Użytkownicy mogą komunikować się poprzez SNS ze swoimi przyjaciółmi, dzielić zdjęciami i nagraniami wideo czy też uczestniczyć w grupach. Wiele funkcji SNS czyni je atrakcyjnymi. SNS zaspokajają potrzeby swoich użytkowników, np. potrzebę przynależności czy potrzebę autoprezentacji. Niełatwo jest znaleźć jedną przyczynę, dla której ludzie korzystają z SNS. Z powodu popularności tego medium, nasuwa się nowe pytanie: czy możliwe jest uzależnienie się od sieci społecznościowych? Naukowcy posługują się terminami, takimi jak: nadmierne korzystanie, problemowe użytkowanie czy nawet uzależnienie, ale wciąż brakuje kryteriów, które mogłyby być pomocne przy identyfikowaniu tego problemu. W artykułach naukowych na temat nadmiernego korzystania z SNS można znaleźć analizy dotyczące czasu spędzanego w sieci i aktywności podejmowanych przez ich użytkowników. Tendencja do uzależnienia od SNS była zazwyczaj mierzona za pomocą kwestionariuszy opracowanych na podstawie skal badających uzależnienie od Internetu. Potrzebne są kolejne badania w tym obszarze, ponieważ SNS wciąż są nowym zjawiskiem i niezbędne jest zróżnicowanie, kiedy użytkowanie jest normą, a kiedy przestaje nią być

Przepływ erytromycyny przez łożysko w ciąży powikłanej zakażeniem paciorkowcami grupy B

Objectives: The aim of this study was to investigate the effectiveness of erythromycin in preventing fetal and intrauterine group B streptococcal (GBS) infections. The study evaluated the penetration of erythromycin through the placenta, by comparing umbilical vein and maternal serum erythromycin concentrations. Material and methods: The study subjects were 42 pregnant women, with GBS-positive screening or whose laboratory screening was not available, who delivered between 17th April 2013 and 22nd July 2013. The women were given 600 mg of erythromycin intravenously. After delivery, blood was drawn from the mother’s antecubital vein and umbilical cord vein. Serum erythromycin concentrations were evaluated using enzyme-linked immunosorbent assay (ELISA) kit. The percentage and correlation between umbilical vein and maternal serum erythromycin concentration were calculated. Based on regression function parameters selected factors: maternal age, maternal body weight, gestational age at delivery, related to the umbilical vein serum erythromycin concentration, were investigated. Results: A total of 42 umbilical vein-maternal serum pairs were included in the analysis. The mean umbilical vein-maternal serum erythromycin concentration percentage was 2,64±1,55%. There was a moderate correlation between umbilical vein serum and maternal serum erythromycin concentration. Pregnancy complications and selected variables of mothers in control group had no effect on the serum erythromycin concentration in the umbilical vein . Conclusions: Intravenous application of erythromycin at a dose of 600 mg, allowed to achieve therapeutic concentration in maternal serum. However, when it comes to placental transfer of erythromycin, the lack of therapeutic concentration in umbilical vein serum was observed. The limited transplacental transfer of erythromycin, which was approximately 2,6%, suggests compromised efficacy in the treatment of intrauterine fetal infections. On the other hand, the placenta seems to produce an effective barrier reducing the fetal exposure when erythromycin is used exclusively to treat maternal infections.Cel: Celem pracy była ocena skuteczności erytromycyny w zapobieganiu infekcjom wewnątrzmacicznym oraz zakażeniem płodu paciorkowcami grupy B (GBS). Dokonano oceny penetracji erytromycyny przez łożysko, poprzez porównanie stężenia leku w surowicy krwi matki i żyle pępowinowej. Materiał i metody: Badaniem objęto 42 ciężarne, z pozytywnym wynikiem badań na nosicielstwo GBS lub dla których wyniki badań nie były znane. Kobiety rodziły w okresie od 17 kwietnia 2013 roku do 22 lipca 2013 roku. Pacjentkom podawano dożylnie 600 mg erytromycyny. Po porodzie pobierano próbki krwi z żyły pępowinowej oraz od matki z żyły łokciowej. Poziom stężenia erytromycyny oceniano z użyciem testu immunoenzymatycznego (ELISA). Obliczono zależność procentową oraz korelację między poziomem stężenia erytromycyny w surowicy krwi matki i w żyle pępowinowej. Na podstawie parametrów funkcji regresji, zbadano zależność między poziomem stężenia erytromycyny w żyle pępowinowej a wybranymi zmiennymi: wiekiem matki, masą ciała matki, wiekiem ciąży . Wyniki: Przezłożyskowy transport erytromycyny w badanej grupie wynosił średnio 2,64±1,55%. Zaobserwowano umiarkowaną korelację między poziomem stężenia erytromycyny w surowicy krwi matki i w żyle pępowinowej. Wybrane zmienne opisujące matkę oraz choroby towarzyszące ciąży nie miały wpływu na poziom stężenia erytromycyny w żyle pępowinowej. Wnioski: Podanie dożylne erytromycyny w dawce 600 mg pozwala na osiągnięcie stężenia terapeutycznego w surowicy krwi matki, jednocześnie obserwuje się słabą penetrację leku do płodu i brak stężenia terapeutycznego w żyle pępowinowej. Ograniczony transport przezłożyskowy erytromycyny, który wynosił średnio 2,6%, sugeruje wątpliwą skuteczność leczenia infekcji wewnątrzmacicznych. Z drugiej strony łożysko stanowi barierę skutecznie chroniącą płód w sytuacji, gdy erytromycyna jest stosowana wyłącznie w celu leczenia matki

Autoimmune reaction against pancreatic beta cells in children and adolescents with simple obesity

IntroductionOne of the most important complications of obesity is insulin resistance, which leads to carbohydrate metabolism disorders such as type 2 diabetes. However, obesity is also associated with development of an autoimmune response against various organs, including pancreatic beta cells. The prevalence of such autoimmune processes in children and their possible contribution to the increased incidence of type 1 diabetes is currently unclear. Therefore, the present study assessed the prevalence of autoantibodies against pancreatic islet beta cell’s antigens in children and adolescents with simple obesity.Material and methodsThis prospective observational study included pediatric patients (up to 18 years of age) with simple obesity hospitalized between 2011 and 2016 at the Department of Pediatrics, Diabetology, Endocrinology and Nephrology of the Medical University of Lodz. Children with acute or chronic conditions that might additionally affect insulin resistance or glucose metabolism were excluded. Collected clinical data included sex, age, sexual maturity ratings (Tanner`s scale), body height and weight, waist and hip circumference, amount of body fat and lean body mass. Each participant underwent a 2-hour oral glucose tolerance test with simultaneous measurements of glycaemia and insulinemia at 0`, 60` and 120`. In addition, glycated hemoglobin HbA1c, fasting and stimulated c-peptide, total cholesterol, as well as high- and low-density cholesterol and triglycerides were measured. Insulin resistance was assessed by calculating HOMA-IR index. The following autoantibodies against pancreatic islet beta cells were determined in each child: ICA - antibodies against cytoplasmic antigens of pancreatic islets, GAD - antibodies against glutamic acid decarboxylase, ZnT8 - antibodies against zinc transporter, IA2 - antibodies against tyrosine phosphatase, IAA – antibodies against insulin.ResultsThe study group included 161 children (57.4% boys, mean age 13.1 ± 2.9 years) with simple obesity (mean BMI z-score +2.2 ± 1.6). Among them, 28 (17.4%) were diagnosed with impaired glucose metabolism during OGTT [23 (82.2%) – isolated impaired glucose tolerance (IGT), 3 (10.7%) – isolated impaired fasting glucose (IFG), 2 (7.1%) – IFG and IGT]. Of the children tested, 28 (17.4%) were tested positive for at least one islet-specific autoantibody [with similar percentages in boys (15, 17.4%) and girls (13, 17.3%), p=0.9855], with ICA being the most common (positive in 18, 11.2%), followed by IAA (7, 4.3%), ZnT8 (5, 3.1%), GADA (3, 1.9%) and IA2 (1, 0.6%). There was no association between the presence of the tested antibodies and age, sex, stage of puberty, parameters assessing the degree of obesity, HbA1c, lipid levels and basal metabolic rate. However, autoantibody-positive subjects were more likely to present IFG or IGT in OGTT compared to those who tested completely negative (9, 32.1% vs 19, 14.3%, p=0.0280). Their HOMA-IR was also significantly higher (HOMA-IR: 4.3 ± 1.9 vs 3.4 ± 1.9, p=0.0203) and this difference remained statistically significant after adjusting for sex and age (p=0.0340).ConclusionsChildren and adolescents with simple obesity presented a higher prevalence of markers of autoimmune response against pancreatic beta cells than the general population. Most often, they had only one type of antibody - ICA. The presence of autoimmune response indicators against pancreatic islet antigens is more common in obese patients with impaired carbohydrate metabolism and is associated with lower insulin sensitivity