Medical University of Gdansk

Purpose The study presents a cross-sectional analysis of the population of Ukrainian women who received maternity care in 11 Polish hospitals. Methods Multidirectional lactation counseling was implemented from March to November 2023 by the Human Milk Bank Foundation in cooperation with UNICEF Refugee Response Office in Poland. Medical data were collected using questionnaires prepared for the study. When the mother indicated that she had mental problems or the health care personnel spotted problems, she was she referred to a psychologist for diagnostics, who used questionnaires appropriate to the patient’s situation such as: Patient Health Questionnaire-9 for depression assessment and Generalized Anxiety Disorder Questionnaire-7 for anxiety assessment. Results In total, 1203 consultations were carried out, of which 542 were lactation counseling, 305 - were physiotherapy, 227 - were psychological, and 129 - were with speech-language pathologists. Two hours of skin-to-skin contact (SSC) and latching on the breast within the 1st hour postpartum occurred in more than half of the participants. In the rest of the population, shortened or lack of SSC was associated with breastfeeding delayed by at least one day. 53% of the population required lactation counseling, of which 242 were one-time visits. Continued support was 98% effective in achieving breastfeeding goals. 167 mothers required psychological support, of which only 53 women continued treatment beyond one-time counseling. Only about 1% of women experienced mental disorders based on a psychological interview. Conclusion The use of lactation counseling more often than psychological counseling by refugee mothers could be related to the beneficial effects of breastfeeding on maternal well-being through hormonal self-regulation and empowerment as a mother. However, focused research is needed on the impact of breastfeeding on the mental health of refugee women.

Nocturnal blood pressure (BP) shows the highest predictive power for cardiovascular events. However, there is a poor reproducibility of personalized dipping patterns in single individuals. We hypothesize that changes in body position during sleep cause variations in hydrostatic pressure,leading to incorrect BP values and dipping classifications. 26 subjects aged 18–30 years, as well as 25 participants aged 50 years and older underwent ambulatory BP measurements on the left arm, as well as determination of the hydrostatic pressure difference between the cuff and heart level during BP measurement. We observed that the BP measurement cuff was above the heart level (negative hydrostatic pressure) mostly through the night. Laying on the right side revealed the largest hydrostatic pressure difference and maximum incorrect BP measurement, with a mean of –9.61 mmHg during sleep. Correcting for hydrostatic pressure led to reclassification of nocturnal hypertension in 14 subjects (27.5%). Dipping patterns changed in 19 participants (37.3%). In total, 25 subjects (49.0%) changed either their nocturnal hypertension and/or their dipping classification. Our findings underscore the importance of accounting for hydrostatic pressure in ambulatory BP monitoring. Changes in body posture during sleep provide a plausible reason for the variability seen in nocturnal dipping patterns. Further research should focus on incorporating hydrostatic pressure compensation mechanisms in 24-h BP measurement. Limiting the noticeable effect of hydrostatic pressure differences could greatly improve hypertension diagnosis, classification, and treatment monitoring.

Objectives Hypertension guidelines recommend the use of single-pill combinations (SPCs) of antihypertensive drugs to improve treatment persistence and blood pressure control. This study aimed to investigate the long-term effects of ramipril/amlodipine (R/A) SPC versus free equivalent dose combinations (FEC) on cardiovascular outcomes and treatment persistence. Methods This retrospective, observational study analysed the database of the Hungarian National Health Insurance Fund. The study included patients with hypertension aged at least 18 years who were initiated on R/A SPC or FEC of different dose combinations (R/A 5/5, 5/10, 10/5 and 10/10 mg) between 2012 and 2018, with follow-up for up to 60 months. Imbalances in baseline characteristics were reduced with propensity score-based sub-classification. All analyses were performed with Cox proportional hazard model and propensity score sub-classification to adjust the imbalances in baseline characteristics. Drug persistence and MACEs were the primary and secondary endpoints, respectively. Results Overall, 104 882 patients with SPC and 68 324 patients with FEC-treated hypertension were included. The R/A 5/5 mg combination represented the largest proportion (62%). The nonpersistence rate was significantly lower with SPC than with FEC from month 1 to month 24 in the R/A 5/5 mg combination ( P < 0.001) and during the entire observation period in the remaining combinations. The MACE rate was significantly reduced with all R/A SPCs versus FECs. No effects on age and sex on both endpoints were noted. Conclusion This study further supports the beneficial effects of the use of SPC on 60-month persistence and MACEs in hypertension.

The impact of obesity on outcomes after adrenalectomy for pheochromocytoma is unclear. This study aims to evaluate outcomes after minimally invasive and open adrenalectomy for pheochromocytoma in patients with obesity and to determine factors that may affect outcomes. Patients undergoing adrenalectomy for pheochromocytoma in 46 international centers between 2012 and 2022 were reviewed, analyzing baseline information, length of hospital stay (LOS), and postoperative complications. Obese (body mass index (BMI) ≥ 30 kg/m2) and nonobese patients were compared. Multivariable analysis was utilized to evaluate outcomes and risk factors for complications, LOS, and increased comprehensive complication index (CCI). Of the 2016 patients, 639 (31.7%) had obesity. Operative time (110.0 versus 105.0 min; p = 0.467), conversion to open rate (3.1% versus 4.7%; p = 0.079), estimated blood loss (20.0 versus 20.0 ml, p = 0.088), rate of complications (19.3% versus 20.8%; p = 0.425), and CCI were similar. However, patients with obesity required a median of 1 day longer LOS (4.0 days versus 5.0 days; p < 0.001). On multivariable analysis, obesity was not significantly associated with complications or higher CCI. Analyzing solely obese patients, laparoscopic (OR 0.24; p < 0.001) and robotic (OR 0.22; p = 0.011) approaches were independently associated with less morbidity. Additionally, multivariable modeling demonstrated that a retroperitoneal approach in patients with BMI ≥ 30 kg/m2 was independently associated with reduced CCI (− 3.74; p = 0.017). Similar results were demonstrated when analyzing severe obesity (BMI ≥ 35). Obesity does not increase complications or CCI following pheochromocytoma resection, but it does increase LOS. A retroperitoneal approach may uniquely benefit patients with obesity. In view of rising obesity rates, these results warrant further research to validate findings.

Regulation of endoplasmic reticulum (ER) homeostasis plays a critical role in maintaining cell survival. When ER stress occurs, a network of three pathways called the unfolded protein response (UPR) is activated to reestablish homeostasis. While it is known that there is cross-talk between these pathways, how this complex network is regulated is not entirely clear. Using human cancer and non-cancer cell lines, two different genome-wide approaches, and two different ER stress models, we searched for miRNAs that were decreased during the UPR and surprisingly found only one, miR-1244, that was found under all these conditions. We also verified that ERstress related downregulation of miR-1244 expression occurred with 5 different ER stressors and was confirmed in another human cell line (HeLa S3). These analyses demonstrated that the outcome of this reduction during ER stress supported both IRE1 signaling and elevated BIP expression. Further analysis using inhibitors specific for IRE1, ATF6, and PERK also revealed that this miRNA is impacted by all three pathways of the UPR. This is the first example of a complex mechanism by which this miRNA serves as a regulatory check point for all 3 pathways that is switched off during UPR activation. In summary, the results indicate that ER stress reduction of miR-1244 expression contributes to the pro-survival arm of UPR.

Cardiovascular complications in patients with autosomal dominant polycystic kidney disease (ADPKD) are frequently investigated extrarenal manifestations with contradictory outcomes. The primary goal of this study is to explore the prevalence of cardiovascular abnormalities using echocardiography and analyze their associations with clinical characteristics at different stages of chronic kidney disease (CKD) progression in ADPKD patients. We included sixty-eight patients in the study. All patients underwent transthoracic echocardiography using GE Vingmed Ultrasound (GE Norway Health Tech, Oslo, Norway). Demographic information, prior medical history, and antihypertensive medication use were recorded. To diagnose the rapid progression of CKD, creatinine levels were measured twice, with a one-year interval. Analysis revealed left ventricular hypertrophy (LVH) in over 40% of ADPKD patients, as indicated by various LVH parameters. Notably, a decline in estimated glomerular filtration rate (eGFR) after one year of observation was associated with increased left ventricular mass. Other prevalent findings included asymptomatic left ventricular diastolic dysfunction (ALVDD) in 39% of patients, left atrium (LA) enlargement in 39%, and mild valvular regurgitations in 80%. Ejection fraction, aortic root dimension, and the prevalence of mitral valve prolapse were not significantly increased. Cardiac indices did not differ substantially across the different eGFR stages. LVH, LA enlargement, ALVDD and valvular regurgitations are characteristics of cardiac phenotype in ADPKD. Cardiac indices were not different across different stages of CKD pointing towards the diagnosis of ADPKD being the main drive of their occurrence.

Liposomes, nanoscale spherical structures composed of amphiphilic lipids, hold great promise for various pharmaceutical applications, especially as nanocarriers in targeted drug delivery, due to their biocompatibility, biodegradability, and low immunogenicity. Understanding the factors influencing their physicochemical properties is crucial for designing and optimizing liposomes. In this study, we have presented the kernel-weighted local polynomial regression (KwLPR) nano-quantitative structure-property relationships (nano-QSPR) model to predict the zeta potential (ZP) based on the structure of 12 liposome formulations, including 1,2-dioleoyl-sn-glycero-3-phosphoethanolamine (DOPE), 3ß-[N-(N′,N′-dimethylaminoethane)-carbamoyl]cholesterol (DC-Chol), 1,2-dioleoyl-3-trimethylammonium-propane (DOTAP), and L-α-phosphatidylcholine (EPC). The developed model is well-fitted (R2 = 0.96, RMSEC = 5.76), flexible (QCVloo2 = 0.83, RMSECVloo = 10.77), and reliable (QExt2= 0.89 RMSEExt = 5.17). Furthermore, we have established the formula for computing molecular nanodescriptors for liposomes, based on constituent lipids’ molar fractions. Through the correlation matrix and principal component analysis (PCA), we have identified two key structural features affecting liposomes’ zeta potential: hydrophilic-lipophilic balance (HLB) and enthalpy of formation. Lower HLB values, indicating a more lipophilic nature, are associated with a higher zeta potential, and thus stability. Higher enthalpy of formation reflects reduced zeta potential and decreased stability of liposomes. We have demonstrated that the nano-QSPR approach allows for a better understanding of how the composition and molecular structure of liposomes affect their zeta potential, filling a gap in ZP nano-QSPR modeling methodologies for nanomaterials (NMs). The proposed proof-of-concept study is the first step in developing a comprehensive and computationally based system for predicting the physicochemical properties of liposomes as one of the most important drug nano-vehicles.

Energy demand has become a persistent concern and high‐performance energy storage systems have increasingly undergone development. Supercapacitors and batteries pose great impact on energy storage and garner a great deal of attention from technologies and researchers alike. The performance of energy saving devices is primarily determined by the electrode material in terms of high specific capacitance, excellent conductivity, remarkable natural abundance, and unique electrochemical qualities, also large surface area. Cobalt (Co)‐based materials are unique electrode materials widely used in energy storage devices. Nevertheless, a combination of Co and ferrite materials such as nickel, zinc, and copper, or Co/nonferrite materials like metal–organic frameworks and layered double hydroxides has improved their ultimate efficiency. This review deals with energy storage applications of Co‐based materials, categorizing ferrites, their electrochemical characterization, performance, also design and manufacturing intended to supercapacitors and batteries applications. Summarizing the main outcomes of the literature on batteries and supercapacitors, energy storage systems comprising Co‐based materials combined with carbon nanotubes, graphene, silica, copper, zinc, nickel, cadmium, ferrous, and lanthanum are reviewed and discussed. Lithium‐ion batteries are investigated specifically, and perspectives on Co‐based ferrite development for future generations of supercapacitors and batteries are outlined.

Doxorubicin ( DOX ) is a cytostatic drug with a broad spectrum of anticancer activity that has been used in oncology for over 50 years. Among many adverse effects in humans, the most dangerous is late dilated cardiomyopathy, which appears even years after completion of therapy. However, in cats, the critical organ for the toxic effects of DOX is the kidney. Herein, nephrotoxicity is manifested as azotemia. The main aim of our study was to evaluate the protective effect of dexrazoxane ( DEX ) and carvedilol ( CVD ) against the nephrotoxic effects of DOX . Nephrotoxicity studies were performed in a rat model of repeated DOX administration. Analyzed blood morphological, biochemical and histopathological findings revealed that DEX has a dual effect: it positively impacts DOX -induced histological alterations and creatinine levels while negatively affecting urea concentration. Thus, the results do not support univocally recommend DEX to prevent nephrotoxicity caused by DOX in cats. However, further studies using initially lower doses of DEX are needed to assess the prevention of nephrotoxicity in cats clinically treated with DOX .

An advanced hybrid nanocomposite based on different metals (copper, cobalt, and chromium) decorated with sustainable polysaccharides (gelatin, GLN, and hydroxyethyl cellulose, HEC) was developed. The composite reflects several advantages including a controlled particle size, particle size distribution, along with promising antimicrobial and anticancer activities. Topographical and elemental analyses were carried out using field-emission scanning electron microscopy (FE-SEM), high-resolution transmission electron microscopy (HR-TEM), and energy dispersive X-ray analysis (EDX), demonstrating the formation of trimetallic nanoparticles (NPs) possessing domain sizes of 169 nm and 102 nm assigned to the free nanocomposite (Fcomp) and loaded nanocomposite (Lcomp), respectively. Moreover, antimicrobial and anticancer activities were evaluated for so-called Cu–Cr–Co-NPs@GLN-HEC nanocomposites. Antimicrobial results revealed that the synthesized Cu–Cr–Co-NPs@GLN-HEC nanocomposite exhibited outstanding antibacterial activity toward S. typhimurium, P. aeruginosa, S. aureus and S. mutans with MICs of 125, 62.5, 125 and 7.81 μg mL⁻¹, respectively. Likewise, the synthesized Cu–Cr–Co-NPs@GLN-HEC nanocomposite showed promising antifungal activity against C. albicans and C. neoformans, with MICs of 31.25 and 15.62 μg mL⁻¹, respectively. Furthermore, the cytotoxicity of Cu–Cr–Co-NPs@GLN-HEC was assessed toward the Wi38 normal cell line, labeled for half-maximal inhibitory concentration (IC50) of 170.8 μg mL⁻¹. Furthermore, the Cu–Cr–Co-NPs@GLN-HEC nanocomposite exhibited strong anticancer activity toward the MCF7 cancerous cell line with IC50 = 30.4 μg mL⁻¹. In conclusion, the synthesized Cu–Cr–Co-NPs@GLN-HEC nanocomposite has promising antibacterial, antifungal and anticancer activities, which can be used in the medical field after excessive experiments in vivo.

Familial hypercholesterolemia (FH) is the most common monogenic disease leading to the accelerated development of atherosclerotic cardiovascular disease (ASCVD). Despite increasing medical knowledge, diagnostic testing, and a growing number of therapeutic options, the effectiveness of detecting and treating FH remains highly insufficient. Only early detection (as early as possible) and optimal treatment in pediatric patients will lead to a significant reduction in morbidity and mortality from atherosclerotic cardiovascular disease (ASCVD) in later years. We present the guidelines for the management of FH in children and adolescents in Poland. This document is an update of the 2014 Position Paper of the Lipid Expert Forum.

Background: Coronary heart disease is the most common cause of death worldwide. It is responsible for almost a third of deaths in patients over the age of 35. Various biomarkers are currently being studied in detail for their value in predicting postoperative mortality in patients undergoing CABG. Aim: The aim of this study is to analyze the predictive value of certain blood morphological parameters in CABG and off-pump coronary artery bypass grafting (OPCAB). Methods: A total of 520 patients who underwent surgery in two consecutive years and underwent CABG (404) or OPCAB (116) were included in this retrospective study. Gender, age, comorbidities, five-year survival rate, detailed information on hospitalization, surgery, intensive care unit parameters and preoperative blood samples from the cubital vein were recorded. Inverse propensity treatment weighting was applied to adjust for confounding factors at baseline. Results: No differences were found between OPCAB and CABG as an isolated comparison. In the standardized population, patients with abnormal lymphocyte counts had an increased risk of death at one-year and five-year follow-up. In the standardized population, abnormal red blood cell distribution width (RDW-SD), neutrocyte-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) were associated with increased mortality in each period analyzed. Conclusions: Abnormal PLR, RDW-SD and NLR are associated with increased early and late mortality in patients undergoing CABG and OPCAB. Abnormal lymphocytes are only associated with increased late mortality.