Advances in medical sciences最新文献_第4页

Characteristics of patients with severe asthma reported to be eligible or non-eligible for biologic therapy in Poland: Results from the international observational study RECOGNISE 波兰报道的符合或不符合生物治疗条件的严重哮喘患者的特征：来自国际观察性研究recognition的结果

IF 2.5 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Advances in medical sciences

Pub Date : 2025-03-01 DOI: 10.1016/j.advms.2025.03.003

Robert M. Mróz , Łukasz Minarowski , Jolanta Biegalska

Purpose

To analyze characteristics of real-world patients with severe asthma in Poland and identify factors determining clinicians’ opinion on the eligibility for biologics.

Methods

In this retrospective, multi-national, single-visit study (NCT03629782), investigators were asked whether the patient might benefit from a referral for further clinical assessment and potentially biologic therapy. Asthma exacerbations and healthcare resource utilization (HCRU) in the last 12 months were documented by the investigators. Patient-reported outcomes included St George's Respiratory Questionnaire (SGRQ) and Asthma Control Questionnaire (ACQ-6).

Results

Of 1025 patients, 146 were enrolled in Poland. Investigators considered 77.4 % of patients eligible for biologics and 22.6 % non-eligible. Patients considered eligible were diagnosed at younger age than non-eligible (median 39 vs 45 years; p = 0.0113) and more frequently had a history of atopy (46 % vs 21.2 %; p = 0.0106). Eligible patients had a higher frequency (93.8 % vs 66.7 %, p < 0.0001) and number of exacerbations (median 2 vs 1, p = 0.0003). Among eligible patients, 81.4 % and among non-eligible, 66.7 % had not well-controlled asthma; long-term oral corticosteroids were used by 46.0 % and 51.5 %, respectively. Short-term corticosteroid use was more frequent in biologics-eligible than in non-eligible patients (82.3 % vs 48.5 %, p < 0.0001). Patients eligible for biologics had a higher median SGRQ total score (64.7 vs 48.4; p = 0.0075) and HRCU (63.7 % vs 9.1 %; p < 0.0001).

Conclusions

In Poland, 3 in 4 patients with severe asthma are recognized by clinicians as potential candidates for biologics. However, eligibility is not associated with long-term oral corticosteroid use, highlighting the need to better inform the physicians about the benefits of biologic therapy.

目的：分析波兰现实世界严重哮喘患者的特征，并确定影响临床医生对生物制剂资格的因素。方法：在这项回顾性、多国、单次来访的研究（NCT03629782）中，研究人员被问及患者是否可能从进一步的临床评估和潜在的生物治疗中获益。研究人员记录了过去12个月的哮喘恶化和医疗资源利用（HCRU）。患者报告的结局包括圣乔治呼吸问卷（SGRQ）和哮喘控制问卷（ACQ-6）。结果：1025例患者中，146例在波兰入组。研究人员认为77.4%的患者符合使用生物制剂的条件，22.6%的患者不符合。被认为符合条件的患者比不符合条件的患者诊断年龄更小(中位39 vs 45岁；P =0.0113)，有特异反应史的患者较多(46% vs 21.2%；p = 0.0106)。符合条件的患者有更高的频率（93.8% vs 66.7%）。结论：在波兰，临床医生认为4例严重哮喘患者中有3例是生物制剂的潜在候选者。然而，适格性与长期口服皮质类固醇使用无关，强调有必要更好地告知医生生物治疗的益处。

{"title":"Characteristics of patients with severe asthma reported to be eligible or non-eligible for biologic therapy in Poland: Results from the international observational study RECOGNISE","authors":"Robert M. Mróz , Łukasz Minarowski , Jolanta Biegalska","doi":"10.1016/j.advms.2025.03.003","DOIUrl":"10.1016/j.advms.2025.03.003","url":null,"abstract":"<div><h3>Purpose</h3><div>To analyze characteristics of real-world patients with severe asthma in Poland and identify factors determining clinicians’ opinion on the eligibility for biologics.</div></div><div><h3>Methods</h3><div>In this retrospective, multi-national, single-visit study (NCT03629782), investigators were asked whether the patient might benefit from a referral for further clinical assessment and potentially biologic therapy. Asthma exacerbations and healthcare resource utilization (HCRU) in the last 12 months were documented by the investigators. Patient-reported outcomes included St George's Respiratory Questionnaire (SGRQ) and Asthma Control Questionnaire (ACQ-6).</div></div><div><h3>Results</h3><div>Of 1025 patients, 146 were enrolled in Poland. Investigators considered 77.4 % of patients eligible for biologics and 22.6 % non-eligible. Patients considered eligible were diagnosed at younger age than non-eligible (median 39 vs 45 years; p = 0.0113) and more frequently had a history of atopy (46 % vs 21.2 %; p = 0.0106). Eligible patients had a higher frequency (93.8 % vs 66.7 %, p < 0.0001) and number of exacerbations (median 2 vs 1, p = 0.0003). Among eligible patients, 81.4 % and among non-eligible, 66.7 % had not well-controlled asthma; long-term oral corticosteroids were used by 46.0 % and 51.5 %, respectively. Short-term corticosteroid use was more frequent in biologics-eligible than in non-eligible patients (82.3 % vs 48.5 %, p < 0.0001). Patients eligible for biologics had a higher median SGRQ total score (64.7 vs 48.4; p = 0.0075) and HRCU (63.7 % vs 9.1 %; p < 0.0001).</div></div><div><h3>Conclusions</h3><div>In Poland, 3 in 4 patients with severe asthma are recognized by clinicians as potential candidates for biologics. However, eligibility is not associated with long-term oral corticosteroid use, highlighting the need to better inform the physicians about the benefits of biologic therapy.</div></div>","PeriodicalId":7347,"journal":{"name":"Advances in medical sciences","volume":"70 1","pages":"Pages 203-208"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143661896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Column chart prediction model for ovarian cancer based on serum ovarian tumor related biomarkers and validation 基于血清卵巢肿瘤相关生物标志物的卵巢癌柱状图预测模型及验证。

IF 2.5 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Advances in medical sciences

Pub Date : 2025-03-01 DOI: 10.1016/j.advms.2025.03.001

Yuting Song , Libo Liu , Jie Gao , Naibao Wu , Jiwei Yin

Purpose

The aim was to study the predictive model and validate serum ovarian tumor-related biomarkers for ovarian cancer histograms.

Method

We randomly selected 181 patients with ovarian tumors and 80 healthy individuals who underwent physical examinations from the hospital's medical record information system as the study participants. Clinical data and detection results of ovarian tumor-related markers such as serum carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), carbohydrate antigen 19-9 (CA19-9), and human epididymal protein (HE4) were collected from all study participants for analysis.

Result

Significant differences were found in serum CEA, CA125, CA19-9, and HE4 levels between healthy controls, benign ovarian tumors, and ovarian cancer (P < 0.05). Dysmenorrhea (present), family history (present), age at menarche, menstrual period, number of pregnancies, natural abortion frequency, number of induced abortions, CEA, CA125, CA19-9, HE4 were all influencing factors for the incidence of ovarian cancer (P < 0.05). The number of induced abortions, CEA, CA125, CA19-9, and HE4 were all independent risk factors for ovarian cancer, while the natural abortion frequency was a protective factor for ovarian cancer (P < 0.05). The constructed column chart prediction model had good discrimination and prediction accuracy for ovarian cancer, good clinical utility, and higher predictive performance for ovarian cancer than traditional ROMA models.

Conclusion

The ovarian cancer column chart prediction model based on serum ovarian tumor related markers has good discrimination and prediction accuracy for ovarian cancer, with high clinical utility. Future research may need to incorporate more serum markers related to ovarian cancer to further improve the performance of predictive models.

目的：研究卵巢癌直方图的预测模型并验证血清卵巢肿瘤相关生物标志物。方法：从医院病历信息系统中随机抽取181例卵巢肿瘤患者和80例健康体检者作为研究对象。收集所有受试者血清癌胚抗原（CEA）、碳水化合物抗原125 （CA125）、碳水化合物抗原19-9 （CA19-9）、人附睾蛋白（HE4）等卵巢肿瘤相关标志物的临床资料及检测结果进行分析。结果：健康对照、良性卵巢肿瘤及卵巢癌患者血清CEA、CA125、CA19-9、HE4水平差异均有统计学意义(p)。结论：基于血清卵巢肿瘤相关标志物的卵巢癌柱状图预测模型对卵巢癌有较好的鉴别和预测准确性，具有较高的临床应用价值。未来的研究可能需要纳入更多与卵巢癌相关的血清标志物，以进一步提高预测模型的性能。

{"title":"Column chart prediction model for ovarian cancer based on serum ovarian tumor related biomarkers and validation","authors":"Yuting Song , Libo Liu , Jie Gao , Naibao Wu , Jiwei Yin","doi":"10.1016/j.advms.2025.03.001","DOIUrl":"10.1016/j.advms.2025.03.001","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim was to study the predictive model and validate serum ovarian tumor-related biomarkers for ovarian cancer histograms.</div></div><div><h3>Method</h3><div>We randomly selected 181 patients with ovarian tumors and 80 healthy individuals who underwent physical examinations from the hospital's medical record information system as the study participants. Clinical data and detection results of ovarian tumor-related markers such as serum carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), carbohydrate antigen 19-9 (CA19-9), and human epididymal protein (HE4) were collected from all study participants for analysis.</div></div><div><h3>Result</h3><div>Significant differences were found in serum CEA, CA125, CA19-9, and HE4 levels between healthy controls, benign ovarian tumors, and ovarian cancer (<em>P</em> < 0.05). Dysmenorrhea (present), family history (present), age at menarche, menstrual period, number of pregnancies, natural abortion frequency, number of induced abortions, CEA, CA125, CA19-9, HE4 were all influencing factors for the incidence of ovarian cancer (<em>P</em> < 0.05). The number of induced abortions, CEA, CA125, CA19-9, and HE4 were all independent risk factors for ovarian cancer, while the natural abortion frequency was a protective factor for ovarian cancer (<em>P</em> < 0.05). The constructed column chart prediction model had good discrimination and prediction accuracy for ovarian cancer, good clinical utility, and higher predictive performance for ovarian cancer than traditional ROMA models.</div></div><div><h3>Conclusion</h3><div>The ovarian cancer column chart prediction model based on serum ovarian tumor related markers has good discrimination and prediction accuracy for ovarian cancer, with high clinical utility. Future research may need to incorporate more serum markers related to ovarian cancer to further improve the performance of predictive models.</div></div>","PeriodicalId":7347,"journal":{"name":"Advances in medical sciences","volume":"70 1","pages":"Pages 209-218"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Conduction system optimized cardiac resynchronization therapy– exceptional modality of cardiac pacing in patients with severe heart failure. A hope for non-responders? 传导系统优化心脏再同步化治疗-严重心力衰竭患者心脏起搏的特殊模式。对无反应者的希望？

IF 2.5 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Advances in medical sciences

Pub Date : 2025-03-01 DOI: 10.1016/j.advms.2025.02.008

Jędrzej Michalik , Maciej Sterliński , Ewa Świerżyńska-Wodarska , Aleksandra Klaus , Marek Szołkiewicz

For many years, the apex of the right ventricle (RV) seemed to be a sufficiently good site for ventricular pacing, effectively protecting both the health and life of patients with atrioventricular conduction disorders. However, the studies have demonstrated that this is not an optimal site, since it leads to electrical and mechanical interventricular asynchrony, which in some cases (15–20 %) results in the development of pacing-induced cardiomyopathy (PICM). The introduction of biventricular cardiac resynchronization therapy (BiV-CRT) into clinical practice was a real breakthrough in the development of modern electrotherapy, and conduction system pacing (CSP) has heralded even greater hopes. The CSP-optimized CRT is the most complex modality of CRT, involving the simultaneous pacing of His bundle or its left branch, and additionally, epicardial pacing of the left ventricle. This modality of pacing may represent the most optimal method for spreading the ventricle depolarization wave in severely damaged cardiac muscle and may represent a real hope for patients who do not adequately respond to other forms of CRT.

多年来，右心室尖部（RV）似乎是一个足够好的心室起搏部位，有效地保护了房室传导障碍患者的健康和生命。然而，研究表明，这不是一个最佳的位置，因为它会导致电性和机械性室间不同步，在某些情况下（15-20%）导致起搏性心肌病（PICM）的发展。双心室心脏再同步化治疗（BiV-CRT）进入临床实践是现代电疗发展的一个真正突破，传导系统起搏（CSP）预示着更大的希望。csp优化的CRT是CRT中最复杂的一种方式，包括His束或其左分支的同时起搏，以及左心室的心外膜起搏。这种起搏方式可能代表了在严重受损的心肌中传播心室去极化波的最佳方法，并且可能代表了对其他形式的CRT没有充分反应的患者的真正希望。

{"title":"Conduction system optimized cardiac resynchronization therapy– exceptional modality of cardiac pacing in patients with severe heart failure. A hope for non-responders?","authors":"Jędrzej Michalik , Maciej Sterliński , Ewa Świerżyńska-Wodarska , Aleksandra Klaus , Marek Szołkiewicz","doi":"10.1016/j.advms.2025.02.008","DOIUrl":"10.1016/j.advms.2025.02.008","url":null,"abstract":"<div><div>For many years, the apex of the right ventricle (RV) seemed to be a sufficiently good site for ventricular pacing, effectively protecting both the health and life of patients with atrioventricular conduction disorders. However, the studies have demonstrated that this is not an optimal site, since it leads to electrical and mechanical interventricular asynchrony, which in some cases (15–20 %) results in the development of pacing-induced cardiomyopathy (PICM). The introduction of biventricular cardiac resynchronization therapy (BiV-CRT) into clinical practice was a real breakthrough in the development of modern electrotherapy, and conduction system pacing (CSP) has heralded even greater hopes. The CSP-optimized CRT is the most complex modality of CRT, involving the simultaneous pacing of His bundle or its left branch, and additionally, epicardial pacing of the left ventricle. This modality of pacing may represent the most optimal method for spreading the ventricle depolarization wave in severely damaged cardiac muscle and may represent a real hope for patients who do not adequately respond to other forms of CRT.</div></div>","PeriodicalId":7347,"journal":{"name":"Advances in medical sciences","volume":"70 1","pages":"Pages 197-202"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Trimethylamine N-oxide as a potential prognostic biomarker for mortality in patients with COVID-19 disease 三甲胺n -氧化物作为COVID-19疾病患者死亡率的潜在预后生物标志物

IF 2.5 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Advances in medical sciences

Pub Date : 2025-03-01 DOI: 10.1016/j.advms.2025.02.002

Zinnet Şevval Aksoyalp , Betül Rabia Erdoğan , Saliha Aksun , Melih Kaan Sözmen , Murat Aksun , Cüneyt Kemal Buharalıoğlu , Nagihan Altıncı-Karahan , Nergiz Hacer Turgut , Tijen Kaya-Temiz

Purpose

Trimethylamine N-oxide (TMAO) is suggested as a biomarker for inflammatory and cardiovascular diseases which are identified as risk factors for severe cases of coronavirus disease 2019 (COVID-19). Our primary aim was to assess prognostic potential of serum TMAO levels in predicting COVID-19-related mortality. The secondary aim was to examine the potential of various biochemical parameters, particularly those associated with inflammation or thrombosis, as predictors of mortality.

Patients and methods

In this prospective and single-centre study, COVID-19 patients were categorized as death (group 1) or discharged (group 2) based on their in-hospital mortality status. The characteristics of participants were documented, and clinical data, including TMAO, angiotensin-converting enzyme-2 (ACE2), and neutrophil to lymphocyte ratio (NLR), were determined. The association of these independent variables with the COVID-19-related mortality, was assessed by calculation of crude odds ratios (OR) in bivariate and logistic regression analysis. Receiver operation characteristic (ROC) analysis was used for cut-off values.

Results

The serum levels of TMAO, ACE2 and NLR were markedly higher in group 1 on the days of hospital admission (p < 0.05, p < 0.05, and p < 0.01, respectively). Serum TMAO levels (OR 1.422; 95 % CI [1.067–1.894]; p = 0.016) and NLR (OR 1.166; 95 % CI [1.012–1.343]; p = 0.033) were determined as independent predictors for COVID-19-related mortality with after multivariate logistic regression analysis. The optimal cut-off values were detected as 7.9 ng/ml for TMAO (71 % sensitivity, 68 % specificity, AUC = 0.701).

Conclusions

The findings of this initial study indicate that serum TMAO levels and NLR may be useful in predicting mortality in the early stages of COVID-19.

目的：三甲胺n -氧化物（TMAO）被认为是炎症和心血管疾病的生物标志物，这些疾病被确定为2019冠状病毒病（COVID-19）重症病例的危险因素。我们的主要目的是评估血清TMAO水平在预测covid -19相关死亡率方面的预后潜力。第二个目的是检查各种生化参数的潜力，特别是与炎症或血栓相关的生化参数，作为死亡率的预测因子。患者和方法：在这项前瞻性单中心研究中，根据住院死亡率情况将COVID-19患者分为死亡组（1组）和出院组（2组）。记录参与者的特征，并确定临床数据，包括TMAO，血管紧张素转换酶-2 （ACE2）和中性粒细胞与淋巴细胞比率（NLR）。在双变量和logistic回归分析中，通过计算粗优势比（OR）来评估这些自变量与covid -19相关死亡率的关联。截断值采用受试者工作特征（ROC）分析。结果：1组患者入院当天血清TMAO、ACE2和NLR水平明显升高(p结论：本初步研究结果提示血清TMAO水平和NLR可能有助于预测COVID-19早期死亡率。

{"title":"Trimethylamine N-oxide as a potential prognostic biomarker for mortality in patients with COVID-19 disease","authors":"Zinnet Şevval Aksoyalp , Betül Rabia Erdoğan , Saliha Aksun , Melih Kaan Sözmen , Murat Aksun , Cüneyt Kemal Buharalıoğlu , Nagihan Altıncı-Karahan , Nergiz Hacer Turgut , Tijen Kaya-Temiz","doi":"10.1016/j.advms.2025.02.002","DOIUrl":"10.1016/j.advms.2025.02.002","url":null,"abstract":"<div><h3>Purpose</h3><div>Trimethylamine N-oxide (TMAO) is suggested as a biomarker for inflammatory and cardiovascular diseases which are identified as risk factors for severe cases of coronavirus disease 2019 (COVID-19). Our primary aim was to assess prognostic potential of serum TMAO levels in predicting COVID-19-related mortality. The secondary aim was to examine the potential of various biochemical parameters, particularly those associated with inflammation or thrombosis, as predictors of mortality.</div></div><div><h3>Patients and methods</h3><div>In this prospective and single-centre study, COVID-19 patients were categorized as death (group 1) or discharged (group 2) based on their in-hospital mortality status. The characteristics of participants were documented, and clinical data, including TMAO, angiotensin-converting enzyme-2 (ACE2), and neutrophil to lymphocyte ratio (NLR), were determined. The association of these independent variables with the COVID-19-related mortality, was assessed by calculation of crude odds ratios (OR) in bivariate and logistic regression analysis. Receiver operation characteristic (ROC) analysis was used for cut-off values.</div></div><div><h3>Results</h3><div>The serum levels of TMAO, ACE2 and NLR were markedly higher in group 1 on the days of hospital admission (<em>p</em> < 0.05, <em>p</em> < 0.05, and <em>p</em> < 0.01, respectively). Serum TMAO levels (OR 1.422; 95 % CI [1.067–1.894]; <em>p</em> = 0.016) and NLR (OR 1.166; 95 % CI [1.012–1.343]; <em>p</em> = 0.033) were determined as independent predictors for COVID-19-related mortality with after multivariate logistic regression analysis. The optimal cut-off values were detected as 7.9 ng/ml for TMAO (71 % sensitivity, 68 % specificity, AUC = 0.701).</div></div><div><h3>Conclusions</h3><div>The findings of this initial study indicate that serum TMAO levels and NLR may be useful in predicting mortality in the early stages of COVID-19.</div></div>","PeriodicalId":7347,"journal":{"name":"Advances in medical sciences","volume":"70 1","pages":"Pages 174-183"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Corrigendum to “Genome-engineering technologies for modeling and treatment of cystic fibrosis” [Adv Med Sci (2023 Sept) 68(1) 111–120] “用于囊性纤维化建模和治疗的基因组工程技术”的勘误表[Journal of the Advances in Medical Sciences卷68/ 1,111 -120(2023),522]。

IF 2.5 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Advances in medical sciences

Pub Date : 2025-03-01 DOI: 10.1016/j.advms.2025.01.009

Michał Dębczyński , Damian Mojsak , Łukasz Minarowski , Monika Maciejewska , Paweł Lisowski , Robert M. Mróz

引用次数: 0

Determinants and dynamics of the seroprevalence of anti-SARS-CoV-2 antibodies in Poland 波兰抗sars - cov -2抗体血清流行率的决定因素和动态

IF 2.5 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Advances in medical sciences

Pub Date : 2025-03-01 DOI: 10.1016/j.advms.2025.03.002

Justyna Adamczuk , Karol Adam Kamiński , Sebastian Sołomacha , Małgorzata Kazberuk , Magdalena Chlabicz , Piotr Czupryna , Justyna Dunaj-Małyszko , Anna Citko , Paweł Sowa , Marlena Dubatówka , Magda Łapińska , Łukasz Kiszkiel , Łukasz Szczerbiński , Piotr Paweł Laskowski , Maciej Alimowski , Anna Moniuszko-Malinowska

Purpose

In the present study, we aimed to assess the anti-SARS-CoV-2 antibodies in population and in convalescents 6 months after infection with COVID-19.

Patients and methods

The study population consisted of 2 groups, i.e. group I: 232 post-COVID-19 patients, and group II: 544 patients from a population cohort.

Detection of anti-N antibodies was performed with Elecsys Anti-SARS-CoV-2 and anti-S antibodies with LIAISON SARS-CoV-2 S1/S2 IgG tests.

Results

After the Omicron wave, gradual increase in the prevalence of the analyzed antibodies was observed in the general population - up to 92.5 % of anti-S and 69.7 % of anti-N antibodies. In the COVID-19 convalescents, 6 months after infection, 4.3 % and 3.7 % did not generate significant titers of anti-S and anti-N antibodies, respectively. Among patients, who were vaccinated, 1 % did not generate anti-S antibodies. The median age of non-responders was higher than that of responders. Sex did not influence the results. Comparison of anti-N and anti-S antibodies 6 months after infection in the whole group showed higher anti-N titer in patients who suffered from the disease than in the general population. In the general population, 17.4 % of participants had anti-N antibodies, and 9 % had anti-S antibodies, despite no prior vaccination or history of COVID-19.

Conclusions

High prevalence of anti-N antibodies in patients reporting no history of COVID-19 during last wave, even after official end of the pandemic suggests high prevalence of SARS-CoV-2 in the environment and frequent asymptomatic or unspecific COVID-19, what is of high importance from the public health perspective.

目的：在本研究中，我们旨在评估COVID-19感染后6个月人群或恢复期人群的抗sars - cov -2抗体水平。患者和方法：研究人群包括2组，即I组：232例covid -19后患者，II组：544例来自人群队列的患者。采用Elecsys anti- cov -2检测抗n抗体，采用LIAISON SARS-CoV-2 S1/S2 IgG检测抗s抗体。结果：经过欧米克隆波后，所分析的抗体在一般人群中的患病率逐渐增加，抗s抗体和抗n抗体的患病率分别高达92.5%和69.7%。在COVID-19恢复期，感染后6个月，分别有4.3%和3.7%的患者抗s抗体和抗n抗体滴度不显著。在接种疫苗的患者中，1%没有产生抗s抗体。无应答者的年龄中位数高于应答者。性别对结果没有影响。全组感染6个月后抗n和抗s抗体比较显示，患病患者的抗n滴度高于一般人群。在一般人群中，17.4%的参与者有抗n抗体，9%的参与者有抗s抗体，尽管之前没有接种疫苗或COVID-19病史。结论：在上一波疫情中，即使在疫情正式结束后，无COVID-19病史的患者中抗n抗体的高流行率提示环境中SARS-CoV-2的高流行率和无症状或非特异性COVID-19的频繁发生，从公共卫生角度来看具有重要意义。

{"title":"Determinants and dynamics of the seroprevalence of anti-SARS-CoV-2 antibodies in Poland","authors":"Justyna Adamczuk , Karol Adam Kamiński , Sebastian Sołomacha , Małgorzata Kazberuk , Magdalena Chlabicz , Piotr Czupryna , Justyna Dunaj-Małyszko , Anna Citko , Paweł Sowa , Marlena Dubatówka , Magda Łapińska , Łukasz Kiszkiel , Łukasz Szczerbiński , Piotr Paweł Laskowski , Maciej Alimowski , Anna Moniuszko-Malinowska","doi":"10.1016/j.advms.2025.03.002","DOIUrl":"10.1016/j.advms.2025.03.002","url":null,"abstract":"<div><h3>Purpose</h3><div>In the present study, we aimed to assess the anti-SARS-CoV-2 antibodies in population and in convalescents 6 months after infection with COVID-19.</div></div><div><h3>Patients and methods</h3><div>The study population consisted of 2 groups, i.e. group I: 232 post-COVID-19 patients, and group II: 544 patients from a population cohort.</div><div>Detection of anti-N antibodies was performed with Elecsys Anti-SARS-CoV-2 and anti-S antibodies with LIAISON SARS-CoV-2 S1/S2 IgG tests.</div></div><div><h3>Results</h3><div>After the Omicron wave, gradual increase in the prevalence of the analyzed antibodies was observed in the general population - up to 92.5 % of anti-S and 69.7 % of anti-N antibodies. In the COVID-19 convalescents, 6 months after infection, 4.3 % and 3.7 % did not generate significant titers of anti-S and anti-N antibodies, respectively. Among patients, who were vaccinated, 1 % did not generate anti-S antibodies. The median age of non-responders was higher than that of responders. Sex did not influence the results. Comparison of anti-N and anti-S antibodies 6 months after infection in the whole group showed higher anti-N titer in patients who suffered from the disease than in the general population. In the general population, 17.4 % of participants had anti-N antibodies, and 9 % had anti-S antibodies, despite no prior vaccination or history of COVID-19.</div></div><div><h3>Conclusions</h3><div>High prevalence of anti-N antibodies in patients reporting no history of COVID-19 during last wave, even after official end of the pandemic suggests high prevalence of SARS-CoV-2 in the environment and frequent asymptomatic or unspecific COVID-19, what is of high importance from the public health perspective.</div></div>","PeriodicalId":7347,"journal":{"name":"Advances in medical sciences","volume":"70 1","pages":"Pages 219-228"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

High levels of soluble neuropilin −1 in critically ill multiple trauma/surgical patients 多发性创伤/外科危重患者高水平可溶性神经匹林-1

IF 2.5 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Advances in medical sciences

Pub Date : 2025-03-01 DOI: 10.1016/j.advms.2025.02.007

Charikleia S. Vrettou, Chrysi Keskinidou , Alice G. Vassiliou , Georgios Poupouzas, Edison Jahaj, Vassilios Issaris, Evangelia Theodorou, Asimenia Halioti, Vassiliki Giannopoulou, Nikolaos S. Lotsios, Anastasia Kotanidou, Ioanna Dimopoulou

Purpose

Critically ill trauma/surgical patients may experience excessive inflammation, immune and coagulation dysregulation, leading to multiple organ failure (MOF), carrying high mortality rates. Neuropilin-1 (NRP-1) and its soluble isoform (sNRP-1) are implicated in immune response regulation, inflammation, and vascular permeability. This study aimed to investigate the possible role of sNRP-1 in trauma/surgical patients in the intensive care unit (ICU).

Patients and methods

This prospective observational study was conducted in a 31-bed ICU and included 81 patients, 43 of whom were trauma/surgical patients and 38 of whom were matched medical patients, comprising the control group. sNRP-1, interleukin (IL)-6, IL-8, and IL-10 levels were measured on admission to the ICU (within 48 h).

Results

Trauma/surgical patients had significantly higher sNRP-1 (p = 0.027), IL-6, IL-8, and IL-10 levels (p < 0.05) compared to medical patients. In the entire cohort, sNRP-1 correlated positively with the international normalized ratio (INR) (p = 0.017), the activated partial thromboplastin time (p = 0.026), fibrinogen (p = 0.027), alanine aminotransferase (p = 0.024), and C-reactive protein (p = 0.004). Moreover, sNRP-1 correlated negatively with total protein (p = 0.035), albumin (p = 0.005), and platelets (p = 0.033).

Conclusion

sNRP-1 levels were elevated in critically ill trauma/surgical patients compared to matched medical ICU patients. Further research is needed to elucidate the exact role of sNRP-1 in these patients' pathophysiology.

目的：创伤/外科危重患者可能出现过度炎症、免疫和凝血功能失调，导致多器官功能衰竭（MOF），死亡率高。神经匹林-1 （NRP-1）及其可溶性异构体（sNRP-1）参与免疫反应调节、炎症和血管通透性。本研究旨在探讨sNRP-1在重症监护病房（ICU）创伤/外科患者中的可能作用。患者和方法：本前瞻性观察性研究在31张床位的ICU进行，纳入81例患者，其中43例为创伤/外科患者，38例为匹配的内科患者，构成对照组。入院时（48小时内）检测sNRP-1、白细胞介素(IL)-6、IL-8、IL-10水平。结果：创伤/外科患者sNRP-1、IL-6、IL-8、IL-10水平显著升高（p = 0.027）。结论：创伤/外科危重症患者sNRP-1水平高于匹配的内科ICU患者。sNRP-1在这些患者病理生理中的确切作用有待进一步研究阐明。

{"title":"High levels of soluble neuropilin −1 in critically ill multiple trauma/surgical patients","authors":"Charikleia S. Vrettou, Chrysi Keskinidou , Alice G. Vassiliou , Georgios Poupouzas, Edison Jahaj, Vassilios Issaris, Evangelia Theodorou, Asimenia Halioti, Vassiliki Giannopoulou, Nikolaos S. Lotsios, Anastasia Kotanidou, Ioanna Dimopoulou","doi":"10.1016/j.advms.2025.02.007","DOIUrl":"10.1016/j.advms.2025.02.007","url":null,"abstract":"<div><h3>Purpose</h3><div>Critically ill trauma/surgical patients may experience excessive inflammation, immune and coagulation dysregulation, leading to multiple organ failure (MOF), carrying high mortality rates. Neuropilin-1 (NRP-1) and its soluble isoform (sNRP-1) are implicated in immune response regulation, inflammation, and vascular permeability. This study aimed to investigate the possible role of sNRP-1 in trauma/surgical patients in the intensive care unit (ICU).</div></div><div><h3>Patients and methods</h3><div>This prospective observational study was conducted in a 31-bed ICU and included 81 patients, 43 of whom were trauma/surgical patients and 38 of whom were matched medical patients, comprising the control group. sNRP-1, interleukin (IL)-6, IL-8, and IL-10 levels were measured on admission to the ICU (within 48 h).</div></div><div><h3>Results</h3><div>Trauma/surgical patients had significantly higher sNRP-1 (p = 0.027), IL-6, IL-8, and IL-10 levels (p < 0.05) compared to medical patients. In the entire cohort, sNRP-1 correlated positively with the international normalized ratio (INR) (p = 0.017), the activated partial thromboplastin time (p = 0.026), fibrinogen (p = 0.027), alanine aminotransferase (p = 0.024), and C-reactive protein (p = 0.004). Moreover, sNRP-1 correlated negatively with total protein (p = 0.035), albumin (p = 0.005), and platelets (p = 0.033).</div></div><div><h3>Conclusion</h3><div>sNRP-1 levels were elevated in critically ill trauma/surgical patients compared to matched medical ICU patients. Further research is needed to elucidate the exact role of sNRP-1 in these patients' pathophysiology.</div></div>","PeriodicalId":7347,"journal":{"name":"Advances in medical sciences","volume":"70 1","pages":"Pages 191-196"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical determinants and long-term survival in heart failure with supra-normal ejection fraction. Insights from LECRA-HF registry 射血分数超常心力衰竭的临床决定因素和长期生存。来自LECRA-HF注册表的见解。

IF 2.5 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Advances in medical sciences

Pub Date : 2025-02-19 DOI: 10.1016/j.advms.2025.02.005

Konrad Stępień , Karolina Eliasz , Karol Nowak , Aleksandra Karcińska , Natalia Kachnic , Alicia del Carmen Yika , Michael Platschek , Krzysztof Krawczyk , Aleksander Siniarski , Jarosław Zalewski , Jadwiga Nessler

Purpose

Heart failure with supra-normal ejection fraction (HFsnEF), defined as HF with left ventricular ejection fraction (LVEF) > 65 %, constitutes a novel HF category. However, its clinical characteristics and long-term outcomes remain insufficiently elucidated. We sought to characterize Polish HFsnEF patients and provide their long-term mortality.

Material and methods

Of 1186 patients enrolled in the single-center Lesser Poland Cracovian Heart Failure (LECRA-HF) registry between years 2009 and 2019, 261 (22 %) were classified as HF with LVEF ≥50 %. Of them, 40 (15.3 %) were classified as HFsnEF, and the remaining 221 (84.7 %) as HF with preserved EF (HFpEF). Baseline characteristics, prior cardiovascular treatment, laboratory and echocardiographic measurements have been collected during index hospitalization. The long-term follow-up of all-cause mortality was obtained from the National Death Registry.

Results

HFsnEF patients were less frequently hypertensive (75 vs 88.2 %, P = 0.026) and they were less often treated with mineralocorticoid receptor antagonists (25 vs 46.2 %, P = 0.013) and loop diuretics (60 vs 76 %, P = 0.017). The Kaplan-Meier analysis showed that all-cause mortality is higher in HFsnEF than in HFpEF (65 vs 55.2 %, P = 0.044). The independent predictors of long-term mortality were age and HFsnEF diagnosis (hazard ratio [HR] 1.037, 95 % confidence interval [CI] 1.018–1.056; HR 1.665, 95 % CI 1.063–2.608, respectively).

Conclusions

Our findings indicate that every 7th Polish patient admitted with HFpEF could be classified as HFsnEF. Baseline characteristics of HFsnEF patients are not significantly different from HFpEF. Simultaneously, in the longest follow-up to date, HFsnEF diagnosis is associated with lower long-term survival.

目的：心力衰竭伴超正常射血分数（HFsnEF），定义为左室射血分数（LVEF）低于65%的HF，是一种新的HF类别。然而，其临床特征和长期结果仍不充分阐明。我们试图描述波兰hfsnf患者的特征，并提供他们的长期死亡率。材料和方法：2009年至2019年，在单中心小波兰克拉科夫心力衰竭（LECRA-HF）登记的1186例患者中，261例（22%）被归类为心力衰竭，LVEF≥50%。其中HFsnEF 40例（15.3%），保留EF (HFpEF) 221例（84.7%）。基线特征，既往心血管治疗，实验室和超声心动图测量收集在索引住院期间。全因死亡率的长期随访来自国家死亡登记处。结果：HFsnEF患者高血压发生率较低（75 vs 88.2%， P=0.026），矿皮质激素受体拮抗剂（25 vs 46.2%， P=0.013）和循环利尿剂（60 vs 76%， P=0.017）的发生率较低。Kaplan-Meier分析显示HFsnEF的全因死亡率高于HFpEF （65% vs 55.2%， P=0.044）。长期死亡率的独立预测因素为年龄和HFsnEF诊断(风险比[HR] 1.037, 95%可信区间[CI] 1.018-1.056；HR为1.665,95% CI为1.063-2.608)。结论：我们的研究结果表明，每7例入院的波兰HFpEF患者中就有1例可归类为HFsnEF。HFsnEF患者的基线特征与HFpEF患者无显著差异。同时，在迄今为止最长的随访中，HFsnEF诊断与较低的长期生存率相关。

{"title":"Clinical determinants and long-term survival in heart failure with supra-normal ejection fraction. Insights from LECRA-HF registry","authors":"Konrad Stępień , Karolina Eliasz , Karol Nowak , Aleksandra Karcińska , Natalia Kachnic , Alicia del Carmen Yika , Michael Platschek , Krzysztof Krawczyk , Aleksander Siniarski , Jarosław Zalewski , Jadwiga Nessler","doi":"10.1016/j.advms.2025.02.005","DOIUrl":"10.1016/j.advms.2025.02.005","url":null,"abstract":"<div><h3>Purpose</h3><div>Heart failure with supra-normal ejection fraction (HFsnEF), defined as HF with left ventricular ejection fraction (LVEF) > 65 %, constitutes a novel HF category. However, its clinical characteristics and long-term outcomes remain insufficiently elucidated. We sought to characterize Polish HFsnEF patients and provide their long-term mortality.</div></div><div><h3>Material and methods</h3><div>Of 1186 patients enrolled in the single-center Lesser Poland Cracovian Heart Failure (LECRA-HF) registry between years 2009 and 2019, 261 (22 %) were classified as HF with LVEF ≥50 %. Of them, 40 (15.3 %) were classified as HFsnEF, and the remaining 221 (84.7 %) as HF with preserved EF (HFpEF). Baseline characteristics, prior cardiovascular treatment, laboratory and echocardiographic measurements have been collected during index hospitalization. The long-term follow-up of all-cause mortality was obtained from the National Death Registry.</div></div><div><h3>Results</h3><div>HFsnEF patients were less frequently hypertensive (75 vs 88.2 %, P = 0.026) and they were less often treated with mineralocorticoid receptor antagonists (25 vs 46.2 %, P = 0.013) and loop diuretics (60 vs 76 %, P = 0.017). The Kaplan-Meier analysis showed that all-cause mortality is higher in HFsnEF than in HFpEF (65 vs 55.2 %, P = 0.044). The independent predictors of long-term mortality were age and HFsnEF diagnosis (hazard ratio [HR] 1.037, 95 % confidence interval [CI] 1.018–1.056; HR 1.665, 95 % CI 1.063–2.608, respectively).</div></div><div><h3>Conclusions</h3><div>Our findings indicate that every 7th Polish patient admitted with HFpEF could be classified as HFsnEF. Baseline characteristics of HFsnEF patients are not significantly different from HFpEF. Simultaneously, in the longest follow-up to date, HFsnEF diagnosis is associated with lower long-term survival.</div></div>","PeriodicalId":7347,"journal":{"name":"Advances in medical sciences","volume":"70 1","pages":"Pages 166-171"},"PeriodicalIF":2.5,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mesenchymal stem cells versus mesenchymal stem cells-derived exosomes as potential autophagy pathway modulators in a diabetic model 间充质干细胞与间充质干细胞衍生的外泌体在糖尿病模型中作为潜在的自噬通路调节剂。

IF 2.5 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Advances in medical sciences

Pub Date : 2025-02-14 DOI: 10.1016/j.advms.2025.02.004

Fatma Y. Meligy , Hanan Sharaf El-Deen Mohammed , Amal T. Abou Elghait , Heba K. Mohamed , Israa El-Sayed Mohamed Ashry , Ayat Abdel-Rahman Sayed , Ola A. Hussein , Ahmed Salman , Tarek Atia , Abir S. Mohamed , Nour H. Behnsawy , Safy Salah Gaber , Hader I. Sakr , Salwa Fares Ahmed

Purpose

This work compared the potential effects of bone marrow mesenchymal stem cells (BM-MSCs) with BM-MSCs-derived exosomes against impaired autophagy in streptozotocin (STZ)-induced diabetic rats.

Materials and methods

Three days after STZ injection, a single dose of (3 × 10^6) BM- MSCs or BM-MSCs-derived exosomes (80 μg/rat) was administered to evaluate their effects against nondiabetic and diabetic control rats. We assessed pancreatic structure via light and electron microscopy and evaluated its staining for insulin and the autophagy marker P62 immunohistochemically. Moreover, autophagy marker LC3 gene expression was examined by PCR.

Results

Both BM-MSCs and BM-MSCs derived exosomes showed histological restoration of pancreatic tissues. Both treatments markedly increased the amount of insulin and significantly decreased the autophagy markers P62 and LC3.

Conclusion

Our findings suggest that both BM-MSCs and BM-MSCs-derived exosomes provides a potential alternative to modulate diabetes mellitus.

目的：本研究比较了骨髓间充质干细胞（BM-MSCs）和BM-MSCs来源的外泌体对链脲佐菌素（STZ）诱导的糖尿病大鼠自噬受损的潜在作用。材料与方法：注射STZ后3 d，给予单剂量（3 × 10 × 6） BM-MSCs或BM-MSCs来源的外泌体（80 μg/大鼠），评估其对非糖尿病和糖尿病对照大鼠的作用。我们通过光镜和电镜评估胰腺结构，并评估其胰岛素和自噬标记物P62的免疫组织化学染色。采用PCR检测自噬标志物LC3基因的表达。结果：BM-MSCs和BM-MSCs衍生的外泌体均表现出胰腺组织的组织学恢复。两种处理均显著提高胰岛素水平，显著降低自噬标志物P62和LC3。结论：我们的研究结果表明，BM-MSCs和BM-MSCs衍生的外泌体都为调节糖尿病提供了一种潜在的选择。

{"title":"Mesenchymal stem cells versus mesenchymal stem cells-derived exosomes as potential autophagy pathway modulators in a diabetic model","authors":"Fatma Y. Meligy , Hanan Sharaf El-Deen Mohammed , Amal T. Abou Elghait , Heba K. Mohamed , Israa El-Sayed Mohamed Ashry , Ayat Abdel-Rahman Sayed , Ola A. Hussein , Ahmed Salman , Tarek Atia , Abir S. Mohamed , Nour H. Behnsawy , Safy Salah Gaber , Hader I. Sakr , Salwa Fares Ahmed","doi":"10.1016/j.advms.2025.02.004","DOIUrl":"10.1016/j.advms.2025.02.004","url":null,"abstract":"<div><h3>Purpose</h3><div>This work compared the potential effects of bone marrow mesenchymal stem cells (BM-MSCs) with BM-MSCs-derived exosomes against impaired autophagy in streptozotocin (STZ)-induced diabetic rats.</div></div><div><h3>Materials and methods</h3><div>Three days after STZ injection, a single dose of (3 × 10^6) BM- MSCs or BM-MSCs-derived exosomes (80 μg/rat) was administered to evaluate their effects against nondiabetic and diabetic control rats. We assessed pancreatic structure via light and electron microscopy and evaluated its staining for insulin and the autophagy marker P62 immunohistochemically. Moreover, autophagy marker LC3 gene expression was examined by PCR.</div></div><div><h3>Results</h3><div>Both BM-MSCs and BM-MSCs derived exosomes showed histological restoration of pancreatic tissues. Both treatments markedly increased the amount of insulin and significantly decreased the autophagy markers P62 and LC3.</div></div><div><h3>Conclusion</h3><div>Our findings suggest that both BM-MSCs and BM-MSCs-derived exosomes provides a potential alternative to modulate diabetes mellitus.</div></div>","PeriodicalId":7347,"journal":{"name":"Advances in medical sciences","volume":"70 1","pages":"Pages 152-165"},"PeriodicalIF":2.5,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Corrigendum to “Effectiveness of antazoline versus amiodarone, flecainide and propafenone in restoring sinus rhythm at the emergency department” [Adv. Med. Sci (2024 Sep) 69(2) 248–255] “安他唑啉与胺碘酮、氟卡因胺和普罗帕酮在急诊科恢复窦性心律的有效性”的勘误表[j]. Journal of Medical Sciences vol . 69/2, 248-255(2024), 591。

IF 2.5 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Advances in medical sciences

Pub Date : 2025-02-08 DOI: 10.1016/j.advms.2025.02.003

Janusz Springer , Michalina Pejska , Wojciech Homenda , Tomasz Zdrojewski , Ludmiła Daniłowicz-Szymanowicz , Dariusz Kozłowski

引用次数: 0