Andrzej Lewiński

Instytut Centrum Zdrowia Matki Polki, Łódź, Łódź Voivodeship, Poland

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Publications (397)566.3 Total impact

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    ABSTRACT: Sclerostin, a protein expressed by osteocytes, is a negative regulator of bone formation. The aim of the study was to investigate the relationship between parathyroid hormone (PTH) and markers of bone metabolism and changes of sclerostin concentrations before and after treatment of hyperthyroidism. Patients and Methods. The study involved 33 patients (26 women), age (mean ± SD) 48 ± 15 years, with hyperthyroidism. Serum sclerostin, PTH, calcium, and bone markers [osteocalcin (OC) and collagen type I cross-linked C-telopeptide I (CTX)] were measured at diagnosis of hyperthyroidism and after treatment with thiamazole. Results. After treatment of hyperthyroidism a significant decrease in free T3 (FT3) and free T4 (FT4) concentrations was accompanied by marked decrease of serum sclerostin (from 43.7 ± 29.3 to 28.1 ± 18.4 pmol/L; p < 0.001), OC (from 35.6 ± 22.0 to 27.0 ± 14.3 ng/mL; p < 0.001), and CTX (from 0.49 ± 0.35 to 0.35 ± 0.23 ng/dL; p < 0.005), accompanied by an increase of PTH (from 29.3 ± 14.9 to 39.8 ± 19.8; p < 0.001). During hyperthyroidism there was a positive correlation between sclerostin and CTX (r s = 0.41, p < 0.05) and between OC and thyroid hormones (with FT3 r s = 0.42, with FT4 r s = 0.45, p < 0.05). Conclusions. Successful treatment of hyperthyroidism results in a significant decrease in serum sclerostin and bone markers concentrations, accompanied by an increase of PTH.
    International Journal of Endocrinology 09/2015; 2015(6):948384. DOI:10.1155/2015/948384 · 1.95 Impact Factor
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    ABSTRACT: Introduction. The presented study is an attempt to comprehensively analyze the lateral spread of heat during thyroidectomy. Obtained results may be valuable in other surgical disciplines in which thermal analysis is difficult or impossible. Objective. The aim of the study was to evaluate the temperature distribution in the operating field during thyroidectomy performed with the use of modern haemostatic instruments, and to define the safety margin for the investigated devices. Materials and methods. Ninety-three patients were thyroidectomised due to thyroid neoplasm. During all the operations the thermovisual measurements were carried out along with continuous intraoperative neuromonitoring of the recurrent laryngeal nerve (CIONM). Investigated patients were divided into 5 groups, named according to the applied haemostatic technique: LigaSure (N=17); ThermoStapler (N=20); Focus (N=19); SonoSurg (N=17) and Monopolar (N=20). Results. At maximal performance settings, the highest working temperature was observed for the ThermoStapler, while the lowest temperature was recorded for the Monopolar. Safety margin and working time were increased in Focus and SonoSurg, compared to LigaSure and ThermoStapler. The differences in the necrosis thickness were negligible. The largest distance of the midline of the active blade from isotherm of 42oC observed in the study was 5.51 mm; none of investigated devices used at a bigger distance had influence on the morphology of the electric signal of CIONM. Conclusion. The thermo-visual camera allows non-invasive, safe, and real-time monitoring and analysis of temperature distribution in the operation area during thyroidectomy. Proposed minimal safety margin for the analysed devices is 5.51 mm.
    Annals of agricultural and environmental medicine: AAEM 09/2015; 22(3):491-494. DOI:10.5604/12321966.1167721 · 1.13 Impact Factor
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    ABSTRACT: Continuous intraoperative neuromonitoring (CIONM) of the recurrent laryngeal nerve is sufficient as the only neuromonitoring technique in thyroidectomy performed because of benign goitre. Ann Agric Environ Abstract Introduction. Recently, intraoperative neurophysiological neuromonitoring (IONM) of recurrent laryngeal nerves (RLN) has been evolving quickly. This evolution touched many aspects of the technique, leading to continuous stimulation of the RLN with real time analysis of the electrical signal. Objective. The aim of the study was to estimate the value of continuous intraoperative neuromonitoring (CIONM) as the only technique for intraoperative neuromonitoring in thyroidectomy performed because of benign goitre. Material and methods. The study comprised 80 women qualified for thyroidectomy due to nodular goitre. The patients were divided into 4 groups depending on the technique used for RLN integrity verification: group 1 – thyroidectomy with CIONM; group 2 – thyroidectomy with direct, intermittent stimulation of RLN and vagus nerve (NX); group 3 – both CIONM and intermittent stimulation of RLN and NX; group 4 – thyroidectomy without any IONM. Results. Mean operation time did not differ significantly among the groups with IONM, but was significantly longer in comparison to group 4, as well as the operation's cost. In the analysed groups there was no significant difference in complication ratio. Conclusion. CIONM with RLN visualization in thyroidectomy performed because of benign goitre is as safe as other methods of IONM and gives a continuous confirmation of the electrical integrity of the loop NX-RLN-vocal folds during almost the entire procedure. There is a clinical need for the development of external stimulation of NX (transdermal or trancranial), particularly for minimally invasive techniques in which access to NX is limited (i.e. transoral thyroidectomy).
    Annals of agricultural and environmental medicine: AAEM 09/2015; 22(223):495-498. DOI:10.5604/12321966.1167722 · 1.13 Impact Factor
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    ABSTRACT: With the reference to the position statements of the Endocrine Society, the Paediatric Endocrine Society, and the European Society of Paediatric Endocrinology, the Polish Society of Endocrinology points out the adverse health effects caused by endocrine disrupting chemicals (EDCs) commonly used in daily life as components of plastics, food containers, pharmaceuticals, and cosmetics. The statement is based on the alarming data about the increase of the prevalence of many endocrine disorders such as: cryptorchidism, precocious puberty in girls and boys, and hormone-dependent cancers (endometrium, breast, prostate). In our opinion, it is of human benefit to conduct epidemiological studies that will enable the estimation of the risk factors of exposure to EDCs and the probability of endocrine disorders. Increasing consumerism and the industrial boom has led to severe pollution of the environment with a corresponding negative impact on human health; thus, there is great necessity for the biomonitoring of EDCs in Poland. (Endokrynol Pol 2015; 66 (3): 276-285).
    Endokrynologia Polska 07/2015; 66(3):276-85. DOI:10.5603/EP.2015.0035 · 0.99 Impact Factor
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    ABSTRACT: Background: Administration of diagnostic activities of 131I, performed in order to detect thyroid remnants after surgery and/or thyroid cancer recurrence/metastases, may lead to reduction of iodine uptake. This phenomenon is called "thyroid stunning". We estimated radiation absorbed dose-dependent changes in genetic material, in particular in sodium iodide symporter (NIS) gene promoter, and NIS protein level in human thyrocytes (HT). Materials and methods: We used unmodified HT isolated from patients subjected to thyroidectomy exposed to 131I in culture. The different 131I activities applied were calculated to result in absorbed doses of 5, 10, and 20 Gy. Results: According to flow cytometry analysis and comet assay, 131I did not influence the HT viability in culture. Temporary increase of 8-oxo-dG concentration in HT directly after 24 h (p < 0.05) and increase in the number of AP-sites 72 h after termination of exposition to 20 Gy dose (p < 0.0001) were observed. The signs of dose-dependent DNA damage were not associated with essential changes in the NIS expression on mRNA and protein levels. Conclusions: Our observation constitutes a first attempt to evaluate the effect of the absorbed dose of 131I on HT. The results have not confirmed the theory that the "thyroid stunning" reduces the NIS protein synthesis.
    International Journal of Molecular Sciences 06/2015; 16(7):14608-14622. DOI:10.3390/ijms160714608 · 2.86 Impact Factor
  • R Stawerska · J Smyczyńska · M Hilczer · A Lewiński
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    ABSTRACT: Aim: It has recently been suggested that prolactin (Prl) level above the upper limit of normal range, recorded in a single measurement in serum is enough to diagnose hyperprolactinemia (HPrl). The aim of the study was the analysis of the circadian rhythm of Prl secretion in children with an increased morning Prl concentration in order to establish whether it is a real hyperprolactinemic state or not. Material and methods: The analysis comprised a group of 44 children (32 boys and 12 girls, aged from 4.2 to 14.1 years, mean±SD: 10.4±3.5 years) with either short stature or precocious puberty, with an elevated Prl concentration at 8:00 a.m., suggesting hyperprolactinemic state. In all patients the circadian Prl secretion profile was assessed on the basis of Prl concentrations in 9 blood samples, collected in 3-h intervals. An analysis of the circadian Prl rhythm was performed. Depending on the medical history and the magnetic resonance imaging result, the children were divided into the following groups: A - congenital disorders of hypothalamic-pituitary region (n=10); B - acquired disorders of hypothalamic-pituitary region (other than pituitary adenomas) (n=15), C - pituitary adenomas (n=19). The control group consisted of 14 healthy children (9 boys and 5 girls), aged from 5.2 to 14.3 years, mean±SD: 10.8±3.2 years. Results: In only 18 children (41%), apart from a higher morning Prl concentration, an elevated Prl concentration at other time points was observed and the circadian rhythm was disturbed, implying hyperprolactinemic state (2 children from Group A, 8 from Group B and 8 form Group C). In the remaining 26 children (59%), higher morning Prl concentrations were not accompanied by elevated Prl concentrations at other time points of the circadian profile. Conclusions: In children with elevated Prl concentrations in the morning, a circadian Prl secretion profile should be performed in order to avoid overdiagnosing of continuous HPrl. In children with the presence of pituitary adenoma and increased morning Prl concentrations, the diagnosis of Prl-secreting adenoma is not completely obvious. © Georg Thieme Verlag KG Stuttgart · New York.
    Experimental and Clinical Endocrinology & Diabetes 06/2015; 123(07). DOI:10.1055/s-0035-1550018 · 1.56 Impact Factor
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    Zbigniew Adamczewski · Andrzej Lewiński
    Thyroid Research 06/2015; 8(Suppl 1):A1. DOI:10.1186/1756-6614-8-S1-A1
  • Thyroid Research 06/2015; 8(Suppl 1):A18. DOI:10.1186/1756-6614-8-S1-A18
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    ABSTRACT: Autoimmune polyglandular syndrome is a constellation of signs and symptoms of simultaneous insufficiencies of several endocrine glands. Autoimmune polyglandular syndrome type 2 (APS 2) may be diagnosed when the adrenocortical insufficiency is associated with an autoimmune thyroid disease (Hashimoto's thyroiditis or Graves' disease), and/or insulin-dependent diabetes mellitus. Turner syndrome is the most common chromosomal disorder in females, caused by complete or partial X chromosome monosomy. We present the case of a 20-year-old woman with Turner syndrome, in whom APS 2 (Hashimoto's thyroiditis and adrenocortical insufficiency) has been diagnosed after introduction of recombinant human growth hormone (rhGH) therapy. In Turner syndrome, examination of the patient must regularly be conducted in order to diagnose a possible onset of autoimmune diseases; respective treatment must be applied as soon as the diagnosis is established. In particular, therapy of rhGH, used for short stature treatment, may be a trigger factor of adrenal insufficiency. The cortisol level in blood should be assessed before rhGH administration and carefully monitored during the therapy, especially in case of autoimmune thyroid disease coexistence.
    Neuro endocrinology letters 05/2015; 36(2):119-123. · 0.80 Impact Factor
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    ABSTRACT: It has always been very difficult to precisely define a goitre. For years, the borderline values have been sought which could be universally used in such evaluations. However, presented reference values were very often disappointing as they proved to be either too restrictive or too liberal. The aim of the study was to assess the two methods of goitre evaluation: 1) traditional, based on ultrasound reference ranges for the thyroid size, 2) based on the analysis of thyroid volume (V) referred to the body surface area (BSA). For this purpose, the study was conducted to evaluate the incidence of goitre and ioduria among 102 school-aged children in Opoczno, Poland. The study group comprised 59 girls and 43 boys; age range: 8-12 years. The incidence of goitre among the examined children varied from 1.0-11.8% in relation to the age, and from 0-14.5% in relation to the BSA, depending on the references ranges used. Analysis of V/BSA ratio is a better estimation of the size of the thyroid gland than the evaluation of thyroid size based on traditional ultrasound reference values. Summing up, relating the size of the thyroid gland to BSA is a good, sensitive tool for such analysis, and can be used for comparisons of different populations, as well as surveys conducted at different time points.
    Annals of agricultural and environmental medicine: AAEM 05/2015; 22(2):301-306. DOI:10.5604/12321966.1152084 · 1.13 Impact Factor
  • Konrad Szosland · Magdalena Stasiak · Andrzej Lewiński
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    ABSTRACT: Laboratory discrimination of pathologic hyperprolactinemia is an important step in the diagnosis of pathology influencing overall health and fertility. A major issue is the choice of time and circumstances for obtaining a blood sample for prolactin assay that would be representative for mean daily plasma concentration of a subject. The aim of the study was a comparison of reliability of single prolactin assessment on various time-points in a day with circadian prolactinemia profile in order to find the easiest, the least expensive, and the most reliable method of hyperprolactinemia diagnosis. The study was a retrospective analysis of 138 women, hospitalized in the Department of Endocrinology and Metabolic Diseases, Polish Mother`s Memorial Hospital - Research Institute, Lodz, Poland, in whom the circadian profile of prolactin (including assays at 8.00 am, 11.00 am, 2.00 pm, 5.00 pm, 8.00 pm, 11.00 pm, 2.00 am, 5.00 am and repeatedly at 8.00 am) had been assessed. On the basis of AUC (area under the curve) of prolactin concentrations, hyperprolactinemia was diagnosed in 34 subjects (24.6 % of the entire group). The attempts to diagnose hyperprolactinemia based on a single prolactin assay failed due to a high percentage of false negative and false positive results. Only significant hyperprolactinemia with mean prolactin concentration of about 100 µg/l or more appeared easy to diagnose. Combinations of several time points also appeared not reliable enough. The nine-point daily profile of prolactinemia in any patient with clinical suspicion of hyperprolactinemia seems the best mode for estimating mean circadian prolactin concentration.
    Annals of agricultural and environmental medicine: AAEM 05/2015; 22(2):332-337. DOI:10.5604/12321966.1152090 · 1.13 Impact Factor
  • 05/2015; DOI:10.1530/endoabs.37.EP132
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    ABSTRACT: A combination of traditional cytology methods with fluorescence activated cell sorting (FACS) analysis of fine-needle aspiration biopsy (FNAB) material is considered a powerful diagnostic tool in the differential diagnosis of thyroid lesions suspected of mucosa-associated lymphoid tissue lymphoma (MALT-L). The aim of this study was to demonstrate the FACS-based diagnostic process of thyroid lesions in a clinical situation where ultrasound and cytological examinations did not allow differentiation between Hashimoto's thyroiditis (HT) and MALT-L. The patients analysed in this study presented significantly different clinical courses of thyroid disease: quickly enlarging painless tumour of the thyroid right lobe in the first case, and chronic HT with palpable tumour in the thyroid isthmus in the second patient. Due to the suspicion of MALT-L resulting from indeterminate ultrasound and FNAB-cytology results, FNAB material was obtained from all the previously examined thyroid lesions and directly subjected to FACS assessment, encompassing κ/λ light chain restriction analysis, as well as measurements of B and T cell surface antigens. The FACS analysis of FNAB material obtained from our patients did not show any definite signs of light chain restriction. Although one of the samples showed a borderline value of κ/λ ratio (κ/λ = 0.31), further immunophenotyping confirmed clonal expansion in none of the examined thyroid regions. Histopathological findings documented the diagnosis of HT in both clinical cases. We believe that FACS represents a useful and reliable complementary diagnostic measure in FNAB-based differential diagnosis of lymphoproliferative thyroid disorders.
    Endokrynologia Polska 03/2015; 66(1):73-8. DOI:10.5603/EP.2015.0001 · 0.99 Impact Factor
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    ABSTRACT: Mitochondrial biogenesis is an essential process for cell viability. Mice with disruption of the growth hormone receptor (GHR) gene (Ghr gene) in the liver (LiGHRKO), in contrast to long-lived mice with global deletion of the Ghr gene (GHRKO), are characterized by lack of improved insulin sensitivity and severe hepatic steatosis. Tissue-specific disruption of the GHR in liver results in a mouse model with dramatically altered GH/IGF1 axis. We have previously shown increased levels of key regulators of mitochondrial biogenesis in insulin-sensitive GHRKO mice. The aim of the present study is to assess, using real-time PCR, the gene expression of key regulators of mitochondrial biogenesis (Pgc1α, Ampk, Sirt1, Nrf2 and Mfn2) and a marker of mitochondrial activity (CoxIV) in brains, kidneys and livers of male and female LiGHRKO and wild-type (WT) mice. There were significant differences between males and females. In the brain, expression of Pgc1α, Ampk, Sirt1, Nrf2 and Mfn2 was lower in pooled females compared to pooled males. In the kidneys, expression of Ampk and Sirt1 was also lower in female mice. In the liver, no differences between males and females were observed. Sexual dimorphism may play an important role in regulating the biogenesis of mitochondria.
    Aging 03/2015; 7(3):195-204. · 6.43 Impact Factor
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    ABSTRACT: Polycystic ovary syndrome (PCOS) is a diagnosis of exclusion. We present two cases of women with oligomenorrhoea and high concentration of androstendione, suggestive of possible androgen-secreting tumour; caused by assay interference. The first patient, investigated for oligomenorrhoea, had no significant hirsutism or acne. Androstendione concentration was above 10.0 ng/ml (rr: 0.3-3.3 ng/ml). In order to rule out possible androgen-secreting tumour or hypercortisolaemia we performed 48-hour low dose dexamethasone suppression test (LDDST). This failed to demonstrate adequate suppression of androstendione (6.05 ng/ml and 9.32 ng/ml after the first and the second day respectively). Pelvic ultrasound examination showed polycystic ovaries, while abdominal CTscan failed to show any ovarian or adrenal lesion. Despite such high androstendione concentrations, urinary steroid profile (gas chromatography/mass spectrometry method) yielded normal results. Hence a possibility of androstendione assay interference was raised. The second patient was also admitted for investigations of oligomenorrhoea. Clinical examination was unremarkable. There was a high concentration of testosterone 0.78 ng/ml (rr. 0.084-0.481 ng/ml) and androstendione above 10.0 ng/ml (rr: 0.3-3.3 ng/ml). LDDST failed to demonstrate any suppression of androstendione, while recalculated concentrations of androstendione after serial dilutions were markedly lower in comparison to initial values. Therefore, such high androstendione concentrations (i.e. above the upper limit of the assay) must have resulted from assay interference. In both cases a final diagnosis of PCOS was established. In the absence of clinical features, contrasting with unusually high androgen levels, a possibility of androgen assay interference should be considered in differential diagnosis of hyperandrogenism or PCOS.
    Ginekologia polska 03/2015; 86(3):229-33. DOI:10.17772/gp/2067 · 0.60 Impact Factor
  • Konrad Szosland · Paweł Pawlowicz · Andrzej Lewinski
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    ABSTRACT: Hyperprolactinemia and polycystic ovary syndrome (PCOS) are on the list of the most frequent causes of female infertility. Both pathologies are characterized in common by several clinical features. At the same time, there are essential discrepancies in medical literature on mutual relations between PCOS and hyperprolactinemia. The objective of our study was to answer several questions, e.g. about frequency of hyperprolactinemia in PCOS patients, typical concentrations of prolactin (Prl) in PCOS patients vs women without polycystic ovaries and/or an assessment of circadian Prl level profiles vs single Prl sampling, as regards diagnostic usefulness. The study was retrospective analysis of medical records of female patients in whom nine (9) points daily profile of prolactinemia had been performed. Prl levels appeared to be slightly higher in women without PCOS but the difference did not reach a border of statistical significance. The incidence of elevated Prl concentrations in 8:00 AM and 11:00 AM samples was higher in women without PCOS than in PCOS patients (32.0% vs 16.3% - 8:00 AM, and 8.5% vs 4.6% - 11:00 AM, respectively). Also, elevated mean daily prolactinemia, assessed as area under the curve (AUC) of Prl concentrations, was more frequent in the group of women without PCOS than in those with PCOS (22.0% vs 13.9%). Polycystic overy syndrome is not associated with higher levels of Prl, measured in daily profiles. Hyperprolactinemia does not seem to be more frequent in PCOS women than in healthy subjects and it should not be considered as characteristic feature of PCOS - both are distinct clinical entities. Prolactin concentrations should be assessed in each woman with PCOS suspicion because of certain common clinical signs in both disorders. Every woman diagnosed with PCOS and hyperprolactinemia should further be examined in terms of the actual causes of hyperprolactinemia because the coexistence of these two disease entities - as distinct - is also possible.
    Neuro endocrinology letters 02/2015; 36(1). · 0.80 Impact Factor
  • J Smyczyńska · R Stawerska · M Hilczer · A Lewiński
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    ABSTRACT: Objective: Growth hormone (GH) deficiency (GHD) has recently been classified as secondary IGF-I deficiency but the significance of IGF-I measurement in diagnosing GHD is still discussed. The aim of the study was to assess the relationships between IGF-I secretion and GH therapy effectiveness in children with GHD. Patients and methods: The analysis comprised 300 children with isolated, non-acquired GHD (GH peak below 10 μg/l) who completed GH therapy and attained final height (FH). In all patients IGF-I concentration was measured before the treatment and IGF-I deficiency was diagnosed if IGF-I SDS for age and sex was below -1.0. The following auxological indices were assessed: patients' height SDS before treatment (H0SDS), FH SDS and improvement of FHSDS vs. H0SDS (ΔHSDS). Results: In the patients with IGF-I deficiency when compared with those with normal IGF-I secretion before treatment, significantly better FH SDS (-1.42±0.90 vs. -1.74±0.86, p=0.004) and ΔHSDS (1.64±1.01 vs. 1.32±1.05, p=0.010) were observed, despite similar H0SDS (- 3.07±0.78 vs. - 3.11±0.77, p=0.63) and GH peak (7.0±3.1 μg/l vs. 6.8±2.1 μg/l, p=0.55). The patients who achieved FH over 10(th) centile had significantly lower IGF-I SDS before treatment than those with FH below 10(th) centile (- 1.59±1.54 vs. - 1.20±1.64, p=0.04), despite similar GH peak (7.0±2.3 μg/l vs. 6.7±3.1 μg/l, p=0.45). The patients with ΔHSDS over the median value had significantly lower IGF-I SDS than those with ΔHSDS below the median value (- 1.59±1.71 vs. - 1.09±1.47, p<0.0001), despite similar GH peak (6.8±2.5 μg/l vs. 7.0±2.7 μg/l, p=0.86). Conclusion: In children with isolated, non-acquired GHD, secondary IGF-I deficiency is an important predictor of better GH therapy effectiveness. © Georg Thieme Verlag KG Stuttgart · New York.
    Experimental and Clinical Endocrinology & Diabetes 01/2015; 123(04). DOI:10.1055/s-0034-1395665 · 1.56 Impact Factor
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    Andrzej Lewiński · Magdalena Marcinkowska
    Thyroid Research 01/2015; 8(Suppl 1):A20. DOI:10.1186/1756-6614-8-S1-A20
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    Andrzej Lewiński · Zbigniew Adamczewski
    Thyroid Research 01/2015; 8(Suppl 1):A19. DOI:10.1186/1756-6614-8-S1-A19
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    ABSTRACT: To evaluate the level of oxidative damage to membrane lipids due to the breast cancer surgery in the early postoperative period. Blood samples were collected on the preoperative day and 24 hours postoperatively in 71 women operated for breast cancer, and preoperatively in 38 female patients with benign breast tumour. Lipid peroxidation (LPO) in the blood samples was estimated by measuring the concentrations of malondialdehyde+4-hydroxyalkenals (MDA+4-HDA) with spectrophotometry. tumour site, tumour histological findings, cancer stage, grade, tumour volume, state of lymph nodes, type of surgery for breast, type of surgery for axilla. Blood LPO level was similar in breast cancer patients and benign tumour patients (2.01±0.46 nmol/ml vs. 1.92±0.39 nmol/ml, respectively; p>0.05). In cancer patients, MDA+4-HDA increased on the first postoperative day, i.e. from 2.01±0.46 nmol/ml to 2.58±0.98 nmol/ml (p=0.0001). In women with benign breast tumour, LPO did not relate to the histological finding (p=0.8915). In the breast cancer group, preoperative LPO did not correlate with age, tumour volume and number of metastatic lymph nodes. Level of MDA+4-HDA was similar in stages I/II (2.03±0.46 nmol/ml) compared to stages III/IV (1.69±0.26 nmol/ml, p=0.1521). Consequently, levels of MDA+4-HDA did not relate to disease stage (p=0.1364). Surgery for breast cancer causes peripheral increase in oxidative damage to macromolecules in the early postoperative period. Therefore, perioperative antioxidant supplementation should be considered.
    Neuro endocrinology letters 12/2014; 35(7):602-607. · 0.80 Impact Factor

Publication Stats

2k Citations
566.30 Total Impact Points


  • 2003–2015
    • Instytut Centrum Zdrowia Matki Polki
      Łódź, Łódź Voivodeship, Poland
  • 2000–2014
    • University of Lodz
      Łódź, Łódź Voivodeship, Poland
    • Wojskowy Instytut Medyczny
      Warszawa, Masovian Voivodeship, Poland
  • 2013
    • Children's Memorial Health Institute
      Warszawa, Masovian Voivodeship, Poland
  • 1984–2013
    • Medical University of Łódź
      Łódź, Łódź Voivodeship, Poland
  • 2011
    • Southern Illinois University School of Medicine
      • Department of Internal Medicine
      Springfield, Illinois, United States
  • 2007–2008
    • Wroclaw Medical University
      • Department and Clinic of Endocrinology, Diabetology and Isotope Therapy
      Wrocław, Lower Silesian Voivodeship, Poland
  • 2004
    • Centrum Medyczne Ksztalcenia Podyplomowego
      Warszawa, Masovian Voivodeship, Poland
  • 2001
    • University of Texas at San Antonio
      San Antonio, Texas, United States
  • 1985–2001
    • University of Texas Health Science Center at San Antonio
      • Department of Cellular and Structural Biology
      San Antonio, Texas, United States