12 research outputs found
Rola marker贸w metabolizmu kostnego w kwalifikacji do leczenia osteoporozy. Wyniki programu POMOST
Introduction: Increased bone turnover markers (BTM) level is consider as independent risk factor of bone fracture. However, it was not
used in 10-year probability of bone fracture method (FRAX) proposed by WHO, which helps in qualification of patients for pharmacological
treatment of osteoporosis. The aim of the study was to evaluate the usefulness of BTM in qualification for pharmacological treatment of
osteoporosis.
Material and methods: The study was performed in 152 subjects (20 men and 132 women) referred to Krajowe Centrum Osteoporozy.
One-hundred thirty two of them were qualified for pharmacological treatment and 20 for prophylaxis on the basis of qualitative method.
The following BTM were examined in all patients: of bone formation - N-terminal propeptide of procolagen type I (PINP) and N-mid
osteocalcin (OC) and of bone resorption - C-terminal cross-linked telopeptide of collagen type I (CTx).
Results: The values over that considered as independent fracture risk (in women only, no data for men) were found in 39 women with
PINP, 39 with OC and 41 with CTx. Part of women had decreased serum BTM (10 women 3 BTM and 35 with 1 at least). There were not
significant differences in serum BTM depending on the presence of clinical fracture risk factors: osteoporotic fracture in past, osteoporotic
hip fracture in parents, chronic treatment with glucocorticosteroids and qualification for pharmacological treatment on the basis of qualitative
and FRAX method. There was no significant difference in the presence of fracture risk factors depending on increased or decreased
serum BTM.
Conclusions: Results of the study did not show the practical use of BTM in qualification for pharmacological treatment of osteoporosis.Wst臋p: Za niezale偶ny czynnik ryzyka z艂amania ko艣ci uwa偶a si臋 podwy偶szenie st臋偶enia marker贸w metabolizmu kostnego (BTM, bone
turnover markers). Nie uwzgl臋dniono tego jednak w metodzie oceny 10-letniego ryzyka z艂amania ko艣ci (FRAX) zaproponowanej przez
艢wiatow膮 Organizacj臋 Zdrowia (WHO, World Health Organization), kt贸ra ma u艂atwia膰 decyzj臋 o farmakologicznym leczeniu osteoporozy.
Celem niniejszej pracy by艂a ocena przydatno艣ci oznaczania st臋偶enia marker贸w metabolizmu kostnego w kwalifikacji do leczenia farmakologicznego
osteoporozy.
Materia艂 i metody: Badania wykonano u 152 os贸b (20 m臋偶czyzn i 132 kobiet), skierowanych do Krajowego Centrum Osteoporozy (KCO),
spo艣r贸d kt贸rych 132 by艂y zakwalifikowane do leczenia, a 20 do profilaktyki osteoporozy na podstawie metody jako艣ciowej stosowanej
w KCO. U wszystkich pacjent贸w oznaczono st臋偶enie w surowicy marker贸w tworzenia ko艣ci: N-ko艅cowy propeptyd prokolagenu typu I
(PINP) i N-ko艅cowy fragment osteokalcyny (OC) oraz resorpcji ko艣ci: C-ko艅cowy usieciowany telopeptyd kolagenu typu I (CTx).
Wyniki: Warto艣ci powy偶ej progu uznanego za niezale偶ny czynnik ryzyka z艂amania ko艣ci stwierdzono u 39 kobiet w przypadku PINP,
39 - OC i 41 - CTx (brak progowych warto艣ci dla m臋偶czyzn). Cz臋艣膰 chorych mia艂a obni偶one st臋偶enie marker贸w w surowicy (10 kobiet
3 markery, 35 co najmniej 1). Nie stwierdzono istotnej r贸偶nicy st臋偶e艅 marker贸w w zale偶no艣ci od obecno艣ci poszczeg贸lnych czynnik贸w
ryzyka z艂amania ko艣ci (przebytego z艂amania osteoporotycznego ko艣ci, z艂amania biodra u rodzic贸w i przewlek艂ego leczenia glikokortykoidami)
oraz od kwalifikacji do leczenia osteoporozy na podstawie metody jako艣ciowej i metody FRAX. Nie by艂o istotnej r贸偶nicy w cz臋sto艣ci
wyst臋powania czynnik贸w ryzyka z艂amania ko艣ci w zale偶no艣ci od obni偶enia czy podwy偶szenia st臋偶e艅 (BTM).
Wnioski: Nie wykazano praktycznego zastosowania oznaczania st臋偶enia marker贸w metabolizmu kostnego przy podejmowaniu decyzji
o konieczno艣ci leczenia farmakologicznego osteoporozy
"The influence of religion on economic development. A case study of Protestantism"
Celem pracy jest analiza przypuszczalnego wp艂ywu religii i zwi膮zanych z ni膮 czynnik贸w na ekonomi臋, gospodark臋 i polityk臋 pa艅stw oraz ich rozwoju. Podj臋to pr贸b臋 wskazania istnienia tego wp艂ywu, jego stopnia, ukierunkowania i genezy. Przybli偶one zosta艂y poj臋cia religii, rozwoju oraz system贸w gospodarczo-ekonomicznych. Opisano najwi臋ksze religie 艣wiata (pod wzgl臋dem liczby ich wyznawc贸w) oraz ich potencjalny wp艂yw na kszta艂towanie si臋 pa艅stwa i jego gospodarki. Przeanalizowano zebrane ekspertyzy, raporty naukowe, publikacje, prace i dane pos艂uguj膮c si臋 analiz膮 tekstu, analiz膮 por贸wnawcz膮, analiz膮 historyczn膮 oraz elementami statystyki. Za pomoc膮 dedukcji i indukcji pr贸bowano po艂膮czy膰 istniej膮ce dane, aby wypracowa膰 nowe wnioski. Przywo艂ano i zinterpretowano hipotez臋 badacza socjologii Maxa Webera dotycz膮c膮 wp艂ywu etyki protestanckiej na rozw贸j kapitalizmu w krajach Europy Zachodniej. Przeanalizowane zosta艂y badania nad kulturami i spo艂ecze艅stwami, r贸偶nicami mi臋dzy nimi i przyczynami tych r贸偶nic. Empiryczne dane opisano pod k膮tem uwarunkowa艅 kulturowych i ich wp艂ywu na kszta艂towanie si臋 gospodarki. Podj臋to pr贸b臋 zinterpretowania zebranych danych w kontek艣cie religii i potencjalnego jej oddzia艂ywania na podane informacje. Og贸lny i bezpo艣redni wp艂yw religii na rozw贸j gospodarczy nie zosta艂 potwierdzony, jednak odnaleziono czynniki kulturowe decyduj膮ce o rozwoju ekonomicznym oraz mo偶liwe ich uwarunkowania religijne. Stwierdzono wzajemne oddzia艂ywanie na siebie religii i kultury, jednak bez konkretnego wskazania kierunku tych oddzia艂ywa艅 oraz ich bezpo艣redniego wp艂ywu na rozw贸j gospodarczy.The purpose of this thesis is to analyse probable influence of religion and related factors on economy and politics, and their development. An attempt was made to show existence of this influence, its size, direction and genesis. Concepts of religion, development and economic formations has been characterized. The biggest world鈥檚 religion (in terms of number of its members) and their potential influence on formatting countries and its economy has been described. The collected expertise, research reports, publications and works have been analysed by text analysis, comparative analysis, historical analysis and by using elements of statistics. Using the deduction and induction the attempt has been made to combine existing data to develop new conclusions. The researcher of sociology, Max Weber's hypothesis about the impact of Protestant to the development of capitalism in Western Europe has been described and interpreted. The research on cultures and societies, the differences between them and the reasons for these differences have been analysed. Empirical data is described in terms of cultural factors and their impact on the development of economy. An attempt was made to interpret the data collected in the context of religion and its potential impact on the information given. General and direct influence of religion on economic development has not been confirmed, however, there have been found cultural factors determining the economic development and the possible religion鈥檚 conditioning. The interaction between religion and culture has been stated, but without a specific indication of the direction of these interaction and its direct impact on economic development
CAUSAL EFFECT RELATIONSHIP IN MEDICAL CASES. AN OLD PROBLEM IN A NEW SCENARIO. COMMENTARY TO CJEU JUDGMENT (SECOND CHAMBER) OF 21 JUNE 2017, N.W. & OTHERS V. SANOFI PASTEUR MSD & OTHERS, CASE C-621/15, EU:C:2017:484 APPROBATIVE GLOSS
This commentary evaluates the problem in assessing the role of a causal connection between damage and the use of a defective medical product, specifically a vaccine. The judgment of the Court of Justice of the European Union (CJEU) in the Sanofi Pasteur Case, which allowed the possibility of recognizing damage claims, even in cases where the prevailing scientific theory claims that there is no scientific evidence of a causal link between a vaccination and the disease, became a base for consideration. Consequently, procedural solutions (such as the standard of proof required, the admissibility of prima facie evidence reasoning and other solutions in cases of an uncertain causation) remain to be decided by national law. The authors assessed two legal systems: the French and Polish legal systems in the context of how to resolve these dilemmas and to describe the impact of the above-mentioned judgment on the case-law of French and Polish courts as regards the application of Directive 85/374/EEC. As a result, they concluded that the most important interpretative motive has become the individual interest of the vaccination鈥檚 victim as a consumer of medical services. It seems to be in accordance with Directive 85/374/EEC, which is motivated by the necessity of approximation of the laws of the Member States concerning the liability of the producer for damage caused by the defectiveness of his products. However, since the existing divergences may distort competition and affect the movement of goods within the common market and entail a differing degree of protection of the consumer against damage caused by a defective product to his health or property, in countries belonging to the European Union, the authors wonder how the commented judgment will affect the further development of consumers protection against defective vaccines
Rekomendacje Grupy Ekspert贸w Polskiego Towarzystwa Ginekolog贸w i Po艂o偶nik贸w dotycz膮ce badania ginekologicznego i leczenia osoby ma艂oletniej (stan na 1.01.2020 r.)
Rekomendacje przedstawiaj膮 aktualny spos贸b post臋powania, kt贸ry mo偶e by膰 zmieniony w uzasadnionych przypadkach, po wnikliwej analizie danej sytuacji klinicznej, co w przysz艂o艣ci mo偶e stanowi膰 podstaw臋 do ich modyfikacji i aktualizacji
Recommendations of the Group of Experts of the Polish Society of Gynecologists and Obstetricians regarding gynecological examination and treatment of a minor person (01.01.2020)
The recommendations present the current knowledge and procedures, which can be modified and changed in some cases, aftercareful analysis of a given clinical situation, which in the future may become the basis for their modification and updating
Extracellular nucleotides enhance procoagulatory profile of endothelial cells after TNF伪 stimulation
Escin attenuates cell migration induced with extracellular nucleotides by reducing sPLA2 activity
WP艁YW WITAMIN ANTYOKSYDACYJNYCH C+E na PRZEBIEG KLINICZNY OSTREGO ZAWA艁U SERCA. Pilotowe, randomizowane, wieloo艣rodkowe, podw贸jnie 艣lepe, kontrolowane placebo badanie MIVIT
Aims. There is a large body of evidence that reactive oxygen species (ROS) produced during myocardial ischemia and
reperfusion play a crucial role in myocardial damage and endothelial dysfunction. The MIVIT pilot trial was designed to test
the effects of antioxidant vitamins C and E on the clinical outcome of patients with AMI.
Methods and results. In this randomized, double-blind, multicenter trial, 800 patients (mean age 62) with AMI were
randomly allocated to receive, on top of routine medication, one of two treatments: vitamin C (1000 mg/12 h infusion)
followed by 1200 mg/24 h orally and vitamin E (600 mg/24 h) or matching placebo for 30 days.
Primary end point (composite of in-hospital cardiac mortality, non-fatal new myocardial infarction, VT/VF/asystole,
shock/pulmonary edema) occurred less frequently in patients treated with antioxidants (55 [14%] vs 75 [19%], OR 0.82 [95%
CI, 0.68-1.00], p=0.048).
Conclusions. This randomized pilot trial shows that supplementation with antioxidant vitamins is safe and seems to
positively influence the clinical outcome of patients with AMI. A larger study is warranted to provide further evidence of this
promising and inexpensive regimen.Wst臋p. Zawa艂 serca stanowi nadal jeden z g艂贸wnych
problem贸w zdrowotnych wsp贸艂czesnego 艣wiata. Istnieja藳
przekonywuj膮ce dane, zar贸wno do艣wiadczalne, jak i kliniczne,
偶e wolne rodniki powstaj膮ce w przebiegu niedokrwienia
i reperfuzji, zaburzaj膮 czynno艣膰 艣r贸db艂onka naczyniowego,
a tak偶e bezpo艣rednio uszkadzaj膮 myocardium. Dotychczasowe
badania do艣wiadczalne, a tak偶e biochemiczne wskazuj膮
na to, 偶e podawanie witamin antyoksydacyjnych w ostrym
zawale serca mo偶e by膰 szczeg贸lnie uzasadnione, bo w艂a艣nie
wtedy procesy oksydacyjne s膮 wybitnie nasilone. Jak dot膮d
brakuje prac klinicznych na ten temat.
Cel badania. Celem niniejszego wieloo艣rodkowego,
randomizowanego, podw贸jnie 艣lepego badania MIVIT jest
ocena bezpiecze艅stwa oraz wp艂ywu na przebieg kliniczny
witamin antyoksydacyjnych C+E u chorych z ostrym zawa艂em
serca.
Grupa badana i metodyka. Badan膮 grup臋 stanowi艂o
800 chorych z ostrym zawa艂em serca, do 24 godzin od
pocz膮tku objaw贸w, kt贸rzy poza standardowym leczeniem,
otrzymywali w spos贸b losowy, witaminy C oraz E lub
placebo. Witamin臋 C podawano zar贸wno do偶ylnie (wlew
1000 mg przez 12 godzin), jak i doustnie (1200 mg/d przez
kolejne 30 dni), za艣 witamin臋 E jedynie doustnie (600 mg/d
przez kolejne 30 dni).
Oceniano przebieg kliniczny choroby w obu podgrupach
badanych w oparciu o g艂贸wny punkt ko艅cowy,
okre艣lony jako wewn膮trzszpitalne zgony sercowe, niezako艅-
czone zgonem VF/VT/asystolia, ci臋偶ka niewydolno艣膰 serca
– obrz臋k p艂uc i wstrz膮s kardiogenny.
Wyniki. Stwierdzono, 偶e u chorych leczonych witaminami
C+E, w por贸wnaniu do otrzymuj膮cych placebo,
rzadziej dochodzi do powik艂a艅 klinicznych okre艣lanych jako
g艂贸wny punkt ko艅cowy (55 [14%] vs 75 [19%], OR 0,82
[95% CI, 0,68-1,00], p=0,048).
Leczenie witaminami antyoksydacyjnymi C+E jest
bezpieczne.
Objawy uboczne ewentualnie zwi膮zane z tym leczeniem
wyst膮pi艂y sporadycznie – podobnie jak w grupie
placebo – i tylko w nielicznych przypadkach sta艂y si臋
powodem ich odstawienia.
Wnioski. Pilotowe, randomizowane, wieloo艣rodkowe,
podw贸jnie 艣lepe, badanie MIVIT wskazuje na to, 偶e
intensywne leczenie witaminami antyoksydacyjnymi chorych
ze 艣wie偶ym zawa艂em serca jest bezpieczne i wp艂ywa
korzystnie na przebieg kliniczny.
Niniejsze badanie uzasadnia potrzeb臋 i wykazuje
celowo艣膰 zainicjowania podobnej pracy na du偶ej populacji
chorych, aby ostatecznie ustali膰 miejsce witamin C+E w leczeniu
ostrego zawa艂u serca
Efficacy and safety of oral l-arginine in acute myocardial infarction. Results of multicenter, randomized, double-blind, placebo-controlled ARAMI pilot trial
Aims: L-arginine is a substrate for nitric oxide (NO) synthesis in vascular endothelial cells. NO bioavailability is decreased during myocardial infarction (MI). It might be expected that administration of L-arginine may maintain NO production and alleviate the course of MI. The aim of the study was to assess safety and effects of treatment with L-arginine on the clinical course of MI.Methods and Results: 792 patients (mean age 64 years, 551 men) with ST segment elevation MI admitted within 24h after the onset of symptoms were randomized to oral L-arginine (3.0 t.i.d p.o. for 30 days) or placebo on top of routine therapy. The end point which was the composite of 30 day cardiovascular death, reinfarction, successful resuscitation, shock/pulmonary edema or recurrent myocardial ischemia occurred in 24% patients treated with L-arginine and 27% with placebo (OR 0.63, 95% CI 0.39-1.02, p=0.06). The end point was observed less frequently in 226 patients with hyperlipidemia (19 vs 31,