Gabriela Handzlik-Orlik

Wstęp: Angiogeneza nowotworowa jest procesem regulowanym przez wiele cytokin i czynników wzrostu, spośród których znaczącą rolę odgrywają czynnik wzrostu śródbłonka naczyń (vascular endothelial growth factor – VEGF), drugi rozpuszczalny receptor dla śródbłonkowego czynnika wzrostu (soluble vascular endothelial growth factor receptor 2 – sVEGFR-2) i galektyna-3. Dane literaturowe dotyczące oceny zmian stężenia VEGF, sVEGFR-2 oraz galektyny-3 w trakcie chemioterapii (chemotherapy – CTH) raka piersi (breast cancer – BC) są niejednoznaczne. Celem niniejszej pracy była analiza stężenia VEGF-A, sVEGFR-2 oraz galektyny-3 w surowicy pacjentek z rakiem piersi, rozpoczynających adjuwantową i neoadjuwantową chemioterapię oraz ocena zmian stężenia tych cytokin w trakcie leczenia.Materiał i metody: Jednoośrodkowe badanie objęło 98 pacjentek z miejscowo zaawansowanym rakiem piersi, w tym 56 poddanych adjuwantowej i 42 neoadjuwantowej terapii. Stężenie VEGF-A, sVEGFR-2 i galektyny-3 w surowicy krwi oceniono na początku leczenia oraz po 2 miesiącach terapii.Wyniki: Nie stwierdzono istotnych różnic pomiędzy stężeniami VEGF-A, sVEGFR-2 oraz galektyny-3 w surowicy pacjentek poddanych adjuwantowej i neoadjuwantowej chemioterapii. Nie wykazano również zależności między stężeniem tych cytokin w surowicy a stopniem zaawansowania klinicznego raka piersi. W trakcie przedoperacyjnej chemioterapii odnotowano znaczące zwiększenie stężenia VEGF-A, sVEGFR-2 i galektyny-3, jednakże zarówno wyjściowe stężenia cytokin, jak i zmiany w czasie nie miały znaczenia predykcyjnego dla uzyskania całkowitej odpowiedzi patologicznej.Wnioski: Stężenia VEGF-A, sVEGFR-2 oraz galektyny-3 w surowicy nie korelują ze stopniem zaawansowania klinicznego ani masą nowotworu u pacjentek z miejscowo zaawansowanym rakiem piersi. Wyjściowe stężenia VEGF-A, sVEGFR-2 i galektyny-3 oraz zaobserwowany wzrost stężeń tych cytokin w surowicy w trakcie chemioterapii nie mają wartości predykcyjnej dla jej skuteczności.

To determine the prevalence of treated and untreated thyroid dysfunction and to identify factors associated with increased risk of undiagnosed thyroid dysfunction in older adults. The population of 5987 community-dwelling Polish Caucasian seniors aged 60 years and above who participated in the PolSenior 2 study (2018–2019). Population-based cross-sectional multidisciplinary study in design. Data from structured questionnaires, geriatric tests, and scales were obtained from all study participants who underwent anthropometric and blood pressure measurements during three home visits. Assessment of thyroid function was based on TSH serum measurements. The prevalence of thyroid dysfunction in the Polish population aged 60 years or above was estimated at 15.5% (21.5% in women and 7.2% in men), with 3.2% of undiagnosed individuals among them. The prevalence of hypothyroidism and hyperthyroidism in the studied group was 13.9% (19.4% in women and 6.3% in men) and 1.6% (2.1% in women and 0.9% in men) respectively, untreated hypothyroidism was revealed in 21.9% (in 160 out of 732 subjects) and untreated hyperthyroidism in 34.2% of subjects (in 41 out of 120 participants). In multiple regression analysis independent risk factors for thyroid disorders being untreated were older age (> 75 years), male sex, a low education level (primary or lower), and low utilization of medical services. One-fifth of Polish Caucasian seniors with hypothyroidism and one-third with hyperthyroidism are untreated. Older, poorly educated and rarely utilizing medical services seniors, especially men, are more frequently untreated for thyroid dysfunction and some of them do not benefit from contemporary achievements in medicine.

Statins are used to reduce a cardiovascular risk. However, the effectiveness of the therapy in many cases remains unsatisfactory. Therefore, the aim of this study was to evaluate the influence of obesity and diabetes on the achievement of therapeutic goal in lipid-lowering therapy in patients with a various cardiovascular risk in the daily clinical practice. This study was conducted on the basis of questionnaires obtained from 7018 patients (41.4% obese, 65.9% viscerally obese and 25.3% diabetics) treated with statins for at least three months. The effectiveness of the treatment was assessed in a subgroup of 3218 patients with a full lipid profile. The LDL-cholesterol target, adjusted for cardiovascular risk, was obtained by 8.1% of patients, less frequently by those with a very high risk of a cardiovascular disease (3.7%), obesity (5.5%), visceral obesity (5.5%) and the type 2 diabetes (5.3%). The obese patients with type 2 diabetes were the least likely to reach the target (3.0%). Male gender, age, the body mass index (BMI)≥28kg/m2, visceral obesity, type 2 diabetes, and a low/moderate statin dose prescription were independent factors decreasing the chance of reaching the low-density lipoprotein (LDL) cholesterol target. 1. The prescribed statin doses do not fully explain the lower frequency of achieving the recommended target in a lipid-lowering therapy in the obese patients and the diabetics. 2. In the daily clinical practice the doses of statins are frequently insufficient and not adjusted for a cardiovascular risk.

Osteoporosis affects a substantial proportion of patients with chronic liver disease. Pathologic fracture in osteoporosis significantly affects quality of life and life expectancy. By some estimates, 40% of patients with chronic liver disease may experience osteoporotic fracture. In this study we review the pathogenesis, diagnosis and treatment of specific liver disease entities and their relation to osteoporosis.

Bariatric surgery is the most effective method of achieving long-lasting weight loss and improving metabolic and cardiovascular outcomes in selected obese patients (i.e. with body mass index [BMI] ≥ 40 kg/m2 without coexisting morbidities or BMI ≥ 35 kg/m2 with severe obesity-related...

Objectives: We aimed to comprehensively evaluate poly-lactide polymer degradation and sirolimus release kinetics from a drug-eluting stent matrix in the in vivo setting using a nuclear magnetic resonance (NMR) method. Methods: In 22 domestic swine, 18 biodegradable polymer-only coated stents (BPSs) and 36 biodegradable polymer-coated sirolimus-eluting stents (BP-SES) were implanted in coronary arteries with 115% overstretch. The animals were sacrificed at 1, 3, 7, 14, 28, and 56 days following baseline procedures. Vessel segments with BPS were harvested to evaluate polymer degradation with a NMR method, whereas BP-SES to analyze sirolimus tissue uptake and retention. Additionally, 8 BP-SES were implanted for histological analysis for 90 days of follow-up. Results: The NMR showed a gradual absorption of the polymer over the 6 consecutive time points, from 5.48 µg of the polymer on the stent at 1-day follow-up, through 4.33 µg at 3 days, 3.16 µg at 7 days, 2.42 µg at 14 days, 1.92 µg at 28 days to 1.24 µg in the last day of the study. The curve of polymer degradation corresponds well with the pharmacokinetic profile of sirolimus eluted from its surface and measured at identical time points. In histopathology, at 90 days, complete healing and biocompatibility were reported. Conclusions: The utilization of NMR method for BP absorption kinetics evaluation is a useful tool, which may be widely adopted to test other biodegradable implants. Further, it may substantially improve their safety and efficacy by facilitating programmed polymer and drugs elution.

Bariatric surgery is considered one of the most effective methods of achieving long‐term weight loss when all other medical treatments have failed. The number of bariatric procedures increases each year. Nevertheless, bariatric procedures are associated with a number of complications that require careful multidisciplinary management. Nutrition supervision is of substantial value, as malnutrition, vitamin, and micro‐ and macronutrient deficiencies may lead to deleterious consequences. In this review, we provide essential information on nutrition management, both before and after bariatric surgical procedures.

Objective To discuss the relationship between adipokines and connective tissue diseases, by putting special emphasis on the potential role of leptin, adiponectin, resistin, and other adipose tissue products in the pathogenesis of rheumatoid arthritis and systemic lupus erythematosus and on possible application of adipokine-targeted therapy in the treatment of these disorders with emphasis on the recent findings. Methods PubMed literature search complemented by review of bibliographies listed in identified articles. Results Most of the data presented by different research groups showed changed levels of leptin, adiponectin, and resistin and occasionally also other adpokines in rheumatoid arthritis and systemic lupus erythematosus. The relationship between the remaining connective tissue diseases and adipokines is less documented. Conclusions Plasma levels of adipokines might tell us too little about their role in connective tissue disorders, whereas adipokine effects on synovial tissues might differ from their known metabolic or cardiovascular effects, which implies that some re-appraisal of adipokines role may need to take place. It still remains obscure whether the observed disturbances in various adipokine systems in subjects with connective tissue diseases contribute to their development or only reflect the presence or activity of inflammatory process, which itself is induced by other pro-inflammatory factors.

Our study aimed to compare the effect of fenofibrate on hemostasis between patients with isolated impaired fasting glucose (IFG) and isolated mixed dyslipidemia and to examine the action of this agent on glucose and lipid metabolism. Twenty-two IFG and 23 mixed dyslipidemic patients were treated for 90 days with micronized fenofibrate (267 mg/day) and were compared with 22 age-, sex- and weight-matched control subjects without lipid and glucose metabolism abnormalities. The lipid profile, fasting and 2-h post-glucose challenge glucose levels, HOMA and glycated hemoglobin as well as the plasma levels/activities of fibrinogen, factor VII and PAI-1 were determined at the beginning and after 30 and 90 days of treatment. Compared to the control subjects, mixed dyslipidemic and IFG patients exhibited increased plasma levels of fibrinogen and PAI-1 as well as increased factor VII activity. Fibrinogen, factor VII and PAI-1 were higher in mixed dyslipidemic than IFG subjects. Not only did fenofibrate improve plasma lipids, but it also increased glucose sensitivity and normalized the IFG- and mixed dyslipidemia-induced changes in coagulation and fibrinolysis. Our study shows that IFG is associated with abnormal hemostasis, which is disturbed to a lesser extent in IFG than in mixed dyslipidemia. Fenofibrate seems to produce a complex beneficial effect on hemostasis in this group of patients.