Polski Merkuriusz Lekarski最新文献

Objective: Aim: To indicate the morphofunctional changes in the endocardium, wall of the arteries of various types, prostate gland, and adrenal glands in the dynamics of iodine deficiency during postnatal ontogenesis.

Patients and methods: Materials and Methods: The experiment involved 50 male Wistar rats (25 immature, aged 3-5 months, and 25 mature, aged 6-8 months). Group 1 (control) included 11 animals of both age groups, while Groups 2 and 3 (with iodine deficiency) consisted of 14 animals each, with material sampling on days 60 and 90 of the experiment, respectively. Morphological (light and electron microscopy), morphometric, biochemical studies, and statistical data processing were conducted.

Results: Results: Key components of thyroid signaling were found in the prostate gland, indicating a possible direct effect of thyroid hormones on this organ. Edematous changes in the epithelium of terminal secretory parts result from ischemia caused by edema in vascular walls and connective tissue elements of the prostate. Structural changes found in endocrine cells of the glomerular, fascicular, and reticular zones of the adrenal glands, along with the dynamic increase in cortical thickness during the experiment, suggest trophic disturbances, as edema was detected in vessel walls and stromal components.

Conclusion: Conclusions: Thus, on both day 60 and day 90 of iodine deficiency, edematous changes occur in all organs in connective tissue components, wall of blood vessels, and epithelial tissues. Altered thyroid status triggers systemic interrelated changes in the organism.

Objective: Aim: To investigate the effect of the phytotherapeutic agent Desolis on cytokine profiles in the secretion of paraurethral glands as part of combination therapy in women with chronic urethritis.

Patients and methods: Materials and Methods: A total of 79 women with chronic urethritis were examined and divided into two groups. The main group (n=40) received standard etiological therapy in accordance with CDC guidelines along with Desolis (administered orally twice daily for 10 days). The control group (n=39) received standard treatment only. Cytokine concentrations in the secretion of the paraurethral glands were determined before and after treatment using ELISA.

Results: Results: Women with chronic urethritis demonstrated significantly elevated levels of pro-inflammatory cytokines (IL-8, IFN-γ, IP-10) and reduced concentrations of IL-2, IL-1β, RANTES, and Fractalkine. The addition of Desolis to treatment led to normalization of these markers, which did not differ significantly from reference values (p>0.05), unlike the control group. Furthermore, patients in the Desolis group experienced a shorter duration of clinical symptoms and significantly higher pathogen elimination rates (87.5% vs. 56.4%, p<0.05).

Conclusion: Conclusions: The use of Desolis in combination therapy contributes to the normalization of the local cytokine profile, improves clinical outcomes, and increases treatment efficacy in women with chronic urethritis.

Objective: Aim: To evaluate the using of fructosamine as a new biomarker in the diagnosis of diabetes mellitus.

Patients and methods: Materials and Methods: This is a cross-sectional case-control study that was conducted at The Medical City, Baghdad/Iraq, from January to May 2024. In this study, 60 diabetic patients were compared with 60 apparently healthy controls. Information was collected from the hospital records and serum fructosamine was measured manually using the nitroblue tetrazolium colorimetric method.

Results: Results: Serum fructosamine levels were significantly higher in diabetic patients (mean=367 μmol/l, SD=12.7) than in the controls (mean=242 μmol/l, SD=22.8), p<0.0001. Logistic regression found that high fructosamine levels were associated with a significantly increased risk of developing diabetes mellitus (odds ratio=1.45; 95% CI: 1.12-1.86; p-value <0.046). Diagnostic performance analysis yielded a sensitivity of 79% and specificity of 73% (p-value=0.033).

Conclusion: Conclusions: Its high levels in the sera of diabetic patients, association with disease risk, and moderate diagnostic accuracy speak for the probable usefulness of this test in clinical practice, these results need confirmation in larger studies.

Objective: Aim: To investigate hepcidin as a marker of iron status in chronic kidney disease (CKD) patients (stage 5 vs. stage 3), and to assess its association with iron injection status within the maintenance hemodialysis group.

Patients and methods: Materials and Methods: This cross-sectional study compared 69 hemodialysis (stage 5 CKD [G1]) and 19 non-dialysis (stage 3 CKD [G2]) patients, assessing hepcidin, ferritin and hemoglobin. As a part of their standard anemia management, patients requiring iron administration received scheduled injections of ferric carboxymaltose.

Results: Results: Hemodialysis patients (G1) had significantly lower hemoglobin and higher anemia prevalence than non-dialysis patients (G2), while baseline hepcidin and ferritin levels were comparable. Importantly, hepcidin levels were above the normal range in 85,5% and 84,2% of G1 and G2 patients, respectively. Hepcidin correlated positively with ferritin in both groups (G1: ρ=0,66, p<0,001; G2: ρ=0,87, p<0,001). Within G1, recent iron injections, administered in 24 patients, were significantly associated with higher hepcidin and ferritin, but not hemoglobin, as compared to patients without additional ferric therapy (n=45) (effect size: r=0,09 [by hemoglobin], r=0,80 [by hepcidin] and r=0,58 [by ferritin]).

Conclusion: Conclusions: Significant iron metabolism impairment, marked by high hepcidin and ferritin prevalence, exists in both CKD stages studied. Although hemodialysis patients had lower hemoglobin, baseline hepcidin/ferritin levels were similar between groups. Within the hemodialysis group, recent iron injections were associated with increased hepcidin/ferritin but not hemoglobin. Findings suggest hepcidin may be a crucial indicator of functional iron availability in CKD, potentially offering more insight than ferritin, particularly reflecting acute changes following iron administration in hemodialysis patients.

Objective: Aim: To evaluate the association between statin use and muscle strength in older adults with heart failure (HF).

Patients and methods: Materials and Methods: Hospitalized, older adults with HF were divided into two subgroups: use statin (US) and not use statin (N-US). Muscle strength was measured using a hand-held dynamometer and HF was assessed based on the New York Heart Association NYHA functional classification.

Results: Results: 194 patients (median age 82 [78-86] years), 90 patients in US and 104 in N-US group. Muscle strength didn't differ significantly in US vs N-US group, 19.74kg (15.48-27.18) vs 17.58kg (12.73-25.66), p=0.098. In a multivariate analysis age, sex, NYHA class, hemoglobin concentration, presence of atrial fibrillation, and hypothyroidism were found to be independent factors of muscle strength (p<0.001, p<0.001, p<0.01, p<0.001, p=0.02, p=0.04 respectively).

Conclusion: Conclusions: statin use is not related to decreased muscle strength in older adults with HF.

Listeria monocytogenes, a Gram-positive bacterium, can cause infections of the nervous system, such as meningitis or encephalitis, with a particular tendency to affect the posterior part of the brain. It can rarely lead to brain abscesses as well. This microorganism is most commonly pathogenic for fetuses, newborns, older individuals, alcoholics, and immunocompromised individuals. The aim of the study was to present three cases of central nervous system listeriosis. Two of presented cases were rhombencephalitis in males without identified predisposing factors. The third case involved a female patient with listerial meningitis during treatment for lymphoma with monoclonal antibodies and vincristine. Neuroimaging of the central nervous system, lumbar punctures, and additional tests were performed in all patients. Antibiotic therapy was administered to all patients according to the literature recommendations. The patient with meningitis was transferred for further treatment to the infectious diseases department. Both patients with rhombencephalitis required treatment in the Intensive Care Unit. One of them unfortunately passed away, while the other required surgical decompression of the posterior cranial fossa and ventricular cerebrospinal fluid drainage, and survived. Listeriosis of the central nervous system is a serious disease, and the number of diagnoses has been increasing in recent years, with cases of rhombencephalitis associated with significant mortality rates. Timely diagnosis is crucial for successful treatment, which is facilitated by the availability of molecular tests in modern times. Diagnosis and treatment require a multidisciplinary approach involving neurologists, radiologists, intensivists, and sometimes even neurosurgeons.

Objective: Aim: Evaluataion of the diagnostic accuracy and clinical utility of the Medicine GPT model in identifying and managing rare diseases in the emergency department.

Patients and methods: Materials and methods: A retrospective study was conducted using 100 published rare case reports retrieved from PubMed. Cases were selected based on three common complaints: chest pain (n = 50), abdominal pain (n = 30), and shortness of breath (n = 20). Each case's clinical presentation was input into Medicine GPT, which then generated a leading diagnosis. The primary outcome was the proportion of correct diagnoses. Cohen's Kappa (κ) was calculated to determine inter-rater reliability. Diagnostic accuracy varied by symptom category: chest pain (92%, κ = 0.84), abdominal pain (87%, κ = 0.81), and shortness of breath (90%, κ = 0.875). Based on full clinical presentations, overall diagnostic agreement reached 90% (κ = 0.84), indicating substantial to almost perfect consistency.

Conclusion: Conclusions: Medicine GPT demonstrated substantial diagnostic accuracy for rare emergency department presentations, indicating potential to enhance clinical decision-making. It may serve as a foundation for refining future AI models in real-world settings, but always should remain only as an assistive tool for professional clinical judgment.

Objective: Aim: To provide a comprehensive understanding of the profound developmental and medical challenges associated with this condition..

Patients and methods: Materials and Methods: Τhis study employed a narrative review methodology, drawing upon a wide range of peer-reviewed scientific literature, clinical guidelines, and case studies. The reviewed materials were selected based on their relevance to the neurocognitive, linguistic, diagnostic, and therapeutic aspects of Edwards syndrome. Databases such as PubMed, Scopus, and Google Scholar were used, with key terms including "Edwards syndrome," "trisomy 18," "developmental delays," "prenatal diagnosis," and "palliative care." Comparative analysis was conducted to explore clinical overlaps with related syndromes such as trisomy 13 and Turner syndrome.

Conclusion: Conclusions: Edwards syndrome presents significant challenges, requiring early diagnosis and multidisciplinary care to improve quality of life. Comprehensive understanding and tailored interventions can foster better outcomes and enhance family support systems.

Objective: Aim: The study aims to review current scientific publications on the genetic study of foetal material in habitual miscarriage with an emphasis on a comparative analysis of the methods used traditional karyotyping and chromosomal microarray analysis. The material in this paper is based on an analysis of scientific publications covering the issues under study over the past five years.

Patients and methods: Materials and Methods: This study reviewed cytogenetic diagnostic methods for detecting genetic abnormalities in foetal material from recurrent miscarriages. A comparative analysis of the widely used methods, karyotyping and chromosomal microarray analysis (CMA), was conducted to assess their strengths and limitations.

Conclusion: Conclusions: Given its superior diagnostic capabilities, CMA should be adopted as the first-line method for investigating genetic abnormalities in cases of habitual miscarriage. Its ability to detect a wider range of chromosomal abnormalities allows for more accurate diagnosis and better-informed clinical decisions. The use of CMA in routine practice can significantly improve the management of future pregnancies, offering couples a greater chance of successful outcomes and providing reproductive health specialists with a more reliable tool for evaluating repeated pregnancy loss.

Objective: Aim: The aim of this study was to investigate and correlate psychosocial risks and musculoskeletal disorders (MSDs) faced by nurses in the hospital work environment..

Patients and methods: Materials and Methods: A cross-sectional study was conducted among 90 nurses (response rate: 56%) working in a General Hospital of Central Greece, from January to March 2023. A self-administered questionnaire was used for data collection, which included demographic information, characteristics of the nursing unit, the Copenhagen Psychosocial Questionnaire Version III (COPSOQ III), and the Nordic Musculoskeletal Questionnaire.

Results: Results: No statistically significant differences were found between individual factors and the COPSOQ scales under examination, except for gender. Professional characteristics, however, were associated with psychosocial risks. For example, an increase in the number of nurses was positively associated with work demands. Conversely, night shifts were negatively associated with freedom of movement, as was the length of employment with opportunities for career development and the assessment of leadership quality. No statistically significant differences were found between MSDs and individual factors. Regarding the correlation between psychosocial risks and MSDs, the study revealed several associations among COPSOQ scales, such as work demands, work-life balance, freedom of movement, social support from colleagues and supervisors, job insecurity and satisfaction, interactions with others, health assessment, and mental exhaustion, with the occurrence of MSDs in body areas such as the neck, shoulders, elbows, wrists, hips, upper back, and ankles.

Conclusion: Conclusions: The hospital work environment entails numerous psychosocial risk factors, and ensuring its safety requires their identification and evaluation. Interventions such as ergonomics training, acquiring ergonomic equipment, avoiding manual lifting, and training on the use of patient handling devices can increase risk awareness, reducing the frequency and intensity of musculoskeletal pain.