Medical University of Lodz

There is a growing body of evidence that urbanization can affect body condition and immune function in wild birds, although these effects may be complex and taxa-specific. Here, we assessed the effects of urbanization on body condition (size-corrected body mass and haemoglobin concentration) and innate immune defences (haemolysis–haemagglutination assay, haptoglobin concentration and bacterial killing assay) in 136 Eurasian coots (Fulica atra) from three urban and three non-urban populations across Poland. We also quantified the heterophil to lymphocyte ratio to control for the potential effect of physiological stress on immune defences. We found that urban coots showed significantly better condition than non-urban ones. At the same time, we found no relationship between any immune defence and urbanization or condition. Thus, our study offers no support for condition-dependent immune function. Our analyses also revealed significant differences between male and female coots in both condition and immune defences; however, we found no evidence for sex-specific responses to urbanization. In conclusion, our study provides correlative evidence that urban habitat enhances condition, but not immune defences in the Eurasian coot.

Introduction: The aim of this study was to implement a model of healthcare for patients with heart failure (HF) and to assess the differences between men and women in the study population. Material and methods: Through care and an extensive educational panel (dietary recommendations, physical activity, titration of diuretics, psychological support), emphasis was placed on prevention. All patients had a baseline cardiology consultation with recommendations regarding treatment, self-care, diet, and exercise. Based on regular measurements of weight and blood pressure HF patients were telemonitored by nurses, primary care physicians and referred to cardiologists when necessary. The questionnaire was conducted in all patients at baseline after enrollment to the study and after 3 months of telemonitoring and extensive educational process. Results: The study finally included 140 men with an average age of 66 years (SD: 56–71) and 163 women with an average age of 64 years (58–72). The ischemic origin of HF was present in 78% of men and 73% of women (p =0.40), and 31% of men and 16% of women declared myocardial infarction in the past (p = 0.002). Men more often survived sudden cardiac arrest (7.8% vs. 1.2%; p = 0.004) and had implantable cardiac devices compared to women (16% vs. 3%; p = 0.001). Male patients reported significantly more often alcohol consumption, smoking, and less frequently any physical activity. Women significantly more often than men suffered from cancer, depression, and thromboembolic events and less frequently from obstructive sleep apnea. The mean left ventricular ejection fraction (LVEF) was 43% (SD: 30–58) for men, and 57% (45–63) for women (p = 0.0001), and women suffered mainly from heart failure with preserved ejection fraction. There were no differences between genders regarding the number of hospitalizations in last 12 months. The men, despite lower LVEF, felt short of breath/tired when climbing the stairs up than women (3 [2–4] vs. 2 floors [1–3]; p = 0.001), had higher distance in meters when walking on flat ground (400 [200–400] vs. 300 m [100–400]; p = 0.0001), and less frequently had to get up to go to the toilet at night (p = 0.03). Men also suffered significantly less often from shortness of breath at rest, swelling of the lower limbs and shortness of breath that wakes them up at night. Only 35% of men and 19% of women had HF self-care training, and only 35% of men and 46% of women knew how to increase the dose of diuretic on their own if shortness of breath or swelling increases. Based on the EuroQol-5 dimensions 5-levels questionnaire, significantly more women than men reported moderate and serious problems with moving around, serious problems with performing ordinary activities independently as well as moderate and serious pain problem and a significant level of anxiety. Men more often than women reported serious problems with self-care. Conclusions: Women suffer more often from HF symptoms and have worse quality of life assessed in EQ-5D-5L than men despite their higher LVEF.

A working group convened by the Section of Multiple Sclerosis and Neuroimmunology of the Polish Neurological Society, the Polish Society of Family Medicine, and the Polish Society of Vaccinology has developed a consensus on supplementary data to the recommendations of the expert group of the Polish Society of Vaccinology, the Polish Society of Family Medicine, the Polish Dermatological Society, the Polish Association for the Study of Pain, and the Polish Neurological Society, and ECTRIMS/EAN of 2023 with regard to the currently available in Poland recombinant herpes zoster vaccine (RZV). It is intended for the prevention of herpes zoster and postherpetic neuralgia in individuals aged > 50 and individuals aged ≥ 18 who belong to herpes zoster risk groups. In Poland it is available with 50% reimbursement exclusively for patients aged 65 and older who have an increased risk of developing herpes zoster. This statement is based on the literature available as of 12 July 2024. The guidance will be updated as new data emerges. All data regarding the above-mentioned vaccine comes from clinical trials which have been reviewed, published and approved by the regulatory authorities and an increasing number of recommendations that might have an impact on real world data.

Background and Aims Overweight and obesity are modifiable risk factors for atherosclerotic cardiovascular disease (ASCVD) in the general population, but their prevalence in individuals with heterozygous familial hypercholesterolaemia (HeFH) and whether they confer additional risk of ASCVD independent of LDL cholesterol (LDL-C) remains unclear. Methods Cross-sectional analysis was conducted in 35 540 patients with HeFH across 50 countries, in the EAS FH Studies Collaboration registry. Prevalence of World Health Organization–defined body mass index categories was investigated in adults (n = 29 265) and children/adolescents (n = 6275); and their association with prevalent ASCVD. Results Globally, 52% of adults and 27% of children with HeFH were overweight or obese, with the highest prevalence noted in Northern Africa/Western Asia. A higher overweight/obesity prevalence was found in non-high-income vs. high-income countries. Median age at familial hypercholesterolaemia diagnosis in adults with obesity was 9 years older than in normal weight adults. Obesity was associated with a more atherogenic lipid profile independent of lipid-lowering medication. Prevalence of coronary artery disease increased progressively across body mass index categories in both children and adults. Compared with normal weight, obesity was associated with higher odds of coronary artery disease in children (odds ratio 9.28, 95% confidence interval 1.77–48.77, adjusted for age, sex, lipids, and lipid-lowering medication) and coronary artery disease and stroke in adults (odds ratio 2.35, 95% confidence interval 2.10–2.63 and odds ratio 1.65, 95% confidence interval 1.27–2.14, respectively), but less consistently with peripheral artery disease. Adjusting for diabetes, hypertension and smoking modestly attenuated the associations. Conclusions Overweight and obesity are common in patients with HeFH and contribute to ASCVD risk from childhood, independent of LDL-C and lipid-lowering medication. Sustained body weight management is needed to reduce the risk of ASCVD in HeFH.

Objective: Professionals working with people after traumatic events can experience both secondary traumatic stress (STS) and secondary posttraumatic growth (SPTG) as a result of exposure to indirect trauma; in both cases, a key role in their development is played by ruminations about the events experienced by the client. The aim of the study was to establish the relationship between STS, ruminations, and SPTG and determine the mediating role of ruminations in the relationship between STS and SPTG in a group of police officers. Method: The study examined 682 police officers exposed to indirect trauma. Most of the respondents were men (75.1%). The mean age of the participants was 40.04 years (SD = 4.41). Three standard measurement tools were used: the Secondary Traumatic Stress Inventory, the Secondary Posttraumatic Growth Inventory, and the Event-Related Rumination Inventory. STS and SPTG were measured twice, with the second measurement taking place 6 months after the first measurement. Results: STS was positively associated with SPTG. Ruminations positively correlated with STS and SPTG. Ruminations, mainly deliberate ones, played a mediating role in the relationship between STS and SPTG in both stages of the study. Conclusions: Both STS and ruminations seem to favor the occurrence of SPTG in police officers working with people after traumatic experiences. Ruminations, especially deliberate ones, play an important role in the transition from the negative to the positive effects of indirect trauma. A tendency for deliberate rumination about the events experienced by the clients can increase the intensity of SPTG.

22q11.2 deletion syndrome (22q11.2DS) is one of the most common congenital malformation syndromes resulting from disrupted embryonic development of pharyngeal pouches. The classical triad of symptoms described by Angelo DiGeorge is frequently accompanied by hematological and immune disorders. While it is well-established that patients with 22q11.2DS have an increased risk of recurrent autoimmune cytopenias, including immune thrombocytopenia, the platelet abnormalities in this population are more complex and multifaceted. Given this issue, we conducted a comprehensive literature review on platelet disorders in 22q11.2DS using accessible databases (PubMed and Scopus). We aimed to outline previous studies limitations and most urgent challenges concerning thrombocytopenia in these patients. One characteristic finding frequently observed in 22q11.2DS is mild macrothrombocytopenia caused presumably by the loss of one GP1BB allele, encoding the element of the GPIb–IX–V complex. This structure plays a central role in thrombocyte adhesion, aggregation, and subsequent activation. Recent studies suggest that defective megakaryopoiesis and impaired vasculogenesis may strongly influence platelet and hemostasis disorders in 22q11.2DS. Furthermore, the phenotypic manifestation may be modulated by epigenetic factors and gene expression modifiers located outside the deletion region. Although the final hemorrhagic phenotype is typically mild, these patients may require more frequent transfusions following major surgical procedures. Despite the risk of thrombocytopenia and thrombocytopathy, there is a lack of large-scale research on hematological anomalies in 22q11.2DS, and the available results are often inconclusive. Given the complexity of hemostatic disorders, it is essential to establish specific recommendations for perioperative management and autoimmune cytopenias treatment within this population.

Background One of the most critical complications that can occur after placing zygomatic implants is the accidental penetration of the patient's eye socket by a drill or implant. This article aims to find some relationships between the anatomical features of the lower orbital wall, different configuration of zygomatic implants, and other factors when planning the placement of zygomatic implants. Methods A total of 81 patients underwent zygomatic implant procedures, receiving different combinations of implants. These included four zygomatic implants along with one or two conventional implants (Group I), four zygomatic implants alone (Group II), two zygomatic implants paired with four conventional implants (Group III), or three zygomatic implants alongside one or two conventional implants (Group IV). The aim of the study was to describe the complications and clinical outcomes of treatment in 81 patients who received zygomatic implants. Results The following parameters were statistically significant between all four groups of patients: height and distance of two zygomatic implants in the zygomatic bone; surgery type and duration; the distance between zygomatic implants in the zygomatic bone; and zygomatic orbital floor (ZOF) classification at the left side showed significant differences; intramaxillary insertion of zygomatic implants reduced the rupture of Schneiderian’s membrane; the average of zygomatic implants’ length in all groups was 42.8 mm. Conclusions Not damaging the ZOF is profoundly important for preventing orbital damage during osteotomy for zygomatic implants and should be measured before every surgery.

Remote mountain lakes experience accelerating ecological change worldwide due to the ongoing warming. In this study, we analyze two alpine lakes, Lake Ana (1940 m) and Lake Peleaga (2122 m), from the Retezat National Park in Romania. The sediment cores cover ~ 400 years, and our aim is to reconstruct critical transitions, the rate of ecosystem change and its driving factors. The extent of human disturbance is weak at these lakes today. Therefore, we assumed the principal role of summer warming in potential ecosystem reorganizations. For verifying this assumption, we use a multi-proxy approach including Pb²¹⁰/Cs¹³⁷ dating, chironomid, pollen, Cladocera analyses, SPDU, element concentration, organic matter, total nitrogen, C/N ratio and δ¹⁵N measurements, chord-distance-analysis (RoC) and chironomid-based temperature reconstruction. The assemblages indicated cold, oligotrophic environment and remained relatively stable despite climate change and human pressure, in contrast to assemblages studied from higher altitude (> 2300 m) lakes in the Alps. Our temperature reconstructions show warming from the 2000’s, but the results are influenced by fish introduction in the 1990s. We conclude that chironomid communities have not yet passed critical thresholds; the fauna reacted with restrained alterations, which is exceptional in the region, and highlight the importance of altitude and environmental protection.

The European Commission authorized the use of dried yellow mealworm (Tenebrio molitor - TM) as a food ingredient under Regulation EU 2021/882. As TM emerges as an important allergen source, sensitization and allergy to TM in various populations need investigation. The aim of this study was to assess the incidence of sensitization to TM before its introduction as a food ingredient in Poland, as well as checking the occurrence of co-sensitivity to TM and other invertebrate allergenic extracts and molecules. This analysis was performed using serum allergen-specific immunoglobulin E (sIgE) results in 6,173 individuals using the ALEX2 test to detect sensitivity to TM and other related allergens. A total of 4.3% of the study population had sIgE to TM extract, with 0.7% of those individuals being mono-sensitized to TM. Sensitization to TM was most commonly associated with a positive response to house cricket and migratory locust allergens. sIgE antibodies against TM significantly more commonly (p < 0.001) co-occurred with sIgE against other invertebrate allergens. Patients with sIgE against TM were most likely sensitised to tropomyosins (49.1% of patients), Niemann-Pick C2 protein (43.8%), group 5/21 allergen (38.6%), class III chitinases (37.1%), and cysteine proteases (34.1%). Based on the serum asIgE levels to TM prior to this ingredient being introduced as a food in Poland, we hypothesised that this primary sensitization may be associated with invertebrate allergies. Our analysis showed that sensitisation to TM was most commonly associated with a positive reaction to house dust mites and shrimp tropomyosins. Therefore, we speculate that individuals allergic to shrimp should exercise caution when consuming foods containing TM.

Aim The aim of this study was to compare the effects of dexmedetomidine, midazolam, propofol, and intralipid on lidocaine-induced cardiotoxicity and neurotoxicity. Methods Forty-eight male Sprague-Dawley rats were randomly divided into six groups (n = 8 per group): control (C), lidocaine (L), lidocaine + dexmedetomidine (LD), lidocaine + midazolam (LM), lidocaine + propofol (LP), and lidocaine + intralipid (LI). Dexmedetomidine (100 µg/kg), midazolam (4 mg/kg), propofol (40 mg/kg), and intralipid (10 mg/kg) were administered intraperitoneally as pretreatment. Lidocaine (90 mg/kg) was administered intraperitoneally to induce oxidative stress in all groups except the control. After 60 minutes of electrocardiography (ECG) recording, the rats were sacrificed, and heart and brain tissue samples were collected. Comparative measurements of total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI), and inflammatory parameters were conducted. Results In heart tissue samples, TAS was significantly higher in LI and LD groups (p < 0.05). Additionally, oxidative stress was significantly higher in the LM group (p < 0.05). Despite an increase in oxidative stress in brain tissue samples across all groups, it was found that all groups exhibited antioxidant protective effects (p < 0.05). Inflammatory parameters in heart and brain tissues significantly decreased in all groups, especially in the LI group (p < 0.05). Conclusion It was observed that pretreatment with midazolam increased oxidative stress induced by lidocaine, while dexmedetomidine and intralipid exhibited greater antioxidant effects. Dexmedetomidine and intralipid used as pretreatment were shown to be more effective in protecting against oxidative stress and inflammation.

Objectives The study evaluated the impact of lifestyle and environmental exposure on the etiology of multiple myeloma (MM). Methods A multicenter case–control study was conducted in 20 hematology centers and in 5 outpatient clinics in Poland. The questionnaire on exposure to potential risk factors including sociodemographic data, lifestyle, and environmental factors was completed. Results A total of 274 patients with newly diagnosed MM and 208 patients from primary healthcare centers in the control group were enrolled in the study. Regarding lifestyle, sports practiced systematically for at least half a year play a protective role in the development of myeloma (OR = 0.40, 95% CI, 0.28–0.58, p < 0.001). Among environmental factors harmful exposures that increase the likelihood of the development of MM include pesticides (OR = 3.29, p < 0.001), asphalt (OR = 2.42, p = 0.026), coal dust (OR = 2.27, p = 0.004), organic vapors (OR = 2.11, p = 0.001), metal dust (OR = 2.07, p = 0.023), exhaust fumes (OR = 2.03, p < 0.01), and chemicals (OR = 1.80, p < 0.01). Conclusions The pathogenesis of MM is complex with the impact of modifiable factors. Lifestyle, with physical activity, seems to play a key role.

Scleromyxedema is a rare chronic fibromucinous disorder characterized by a generalized papular and sclerodermoid eruption. Despite its clinical significance, no definitive therapeutic guidelines exist for scleromyxedema, making management challenging. Herein, we present a case of a 76-year-old female patient referred for evaluation of systemic sclerosis, presenting with distinctive cutaneous manifestations and neurological symptoms. Investigations revealed monoclonal gammopathy (IgG Lambda subtype) and antinuclear antibodies, supporting a diagnosis of scleromyxedema. A multidisciplinary approach with intravenous immunoglobulin (IVIG) therapy resulted in significant improvement in neurological and cutaneous symptoms. This case underscores the challenges of diagnosing and managing scleromyxedema and highlights IVIG as a potential therapeutic option in the absence of standardized guidelines.

A study of the early life history stages of fishes (ELH) in the area of the Połaniec Power Plant (PPP), the second largest power plant with an open cooling system located on the Vistula River, was conducted. Using next-generation sequencing, 17 fish species were found in the drift, five of which are protected by international (Natura 2000) or national law. It was estimated that in the spring and summer of 2023 from 10 to 17 × 106 ind. ELH, including 22–23% of protected species, was probably entrained and killed in the cooling system of the PPP. The water temperature within the mixing zone was found to be noticeably elevated (by an average of 5.5°C). In addition, a pronounced hydropeaking phenomenon was observed after the ELH sampling period (since spring 2024). All these pressures overlapping can cause very unfavorable conditions for aquatic organisms in the Upper Vistula River.