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Intensyfikacja regularnej aktywności fizycznej u pacjentów z opornym nadciśnieniem tętniczym

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Kruk P., Nowicki M.

Pediatria i Medycyna Rodzinna

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2017

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vol. 13

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issue 3

368-376

EN

Introduction: Regular physical activity is recommended in patients with arterial hypertension as part of the necessary lifestyle modifications. Aim of the study: The aim of the study was to assess the possibility of increasing the physical activity of patients with resistant hypertension. Material and methods: The study group consisted of 27 patients meeting the diagnosis criteria of resistant hypertension and 26 patients with well-controlled hypertension, as a control group. Anthropometric and bioimpedance-based body composition measurements were performed three times within the course of the 6-month-long study, at baseline and after 3 and 6 months, and a physical activity profile was determined based on the International Physical Activity Questionnaire. The study also included accelerometer measurements conducted for 72 consecutive hours. The participants were recommended to perform regular aerobic physical activity, chosen individually during meetings with the study scientist, in accordance with the guidelines of the American Heart Association. Moreover, the patients were motivated to perform physical activity with short text messages and phone calls. Results: A significant change in the resistant hypertensives was observed after 6 months, regarding the number of steps taken (17,361 ± 6,815 vs. 23,067 ± 7,741; p < 0.005), metabolic equivalent of task (1.325 ± 0.3 vs. 1.464 ± 0.3; p = 0.001), duration of rest (1,595 ± 265 vs. 1,458 ± 292 min; p < 0.05) and sleep (1,278 ± 228 vs. 1,147 ± 270 min; p = 0.02), as assessed based on 3-day accelerometer measurements. An increase in activity was also observed based on the International Physical Activity Questionnaire and positive changes in body composition were determined. Conclusions: In the case of patients with resistant hypertension, intensification of physical activity is a well-tolerated, implementable and cost-effective therapeutic intervention.

PL

Wprowadzenie: Regularna aktywność fizyczna jest zalecana w przypadku chorych na nadciśnienie tętnicze – jako element niezbędnej modyfikacji stylu życia. Cel badania: Celem badania była ocena możliwości zwiększenia aktywności ruchowej u pacjentów z nadciśnieniem opornym na leczenie. Materiał i metody: Do badania zakwalifikowano 53 osoby, w tym 27 pacjentów spełniających kryteria rozpoznania nadciśnienia tętniczego opornego oraz 26 pacjentów z nadciśnieniem tętniczym dobrze kontrolowanym, stanowiących grupę porównawczą. W trakcie trwającego 6 miesięcy badania wykonano trzykrotnie – wyjściowo, po 3 i po 6 miesiącach – pomiary antropometryczne i składu ciała metodą bioimpedancji elektrycznej oraz określono profil aktywności ruchowej, stosując Międzynarodowy Kwestionariusz Aktywności Fizycznej. Badanie obejmowało także pomiary akcelerometryczne, prowadzone przez kolejne 72 godziny. Uczestnikom zalecano regularną aktywność fizyczną aerobową – zgodną z aktualnymi zaleceniami Amerykańskiego Towarzystwa Kardiologicznego, indywidualizowaną w trakcie spotkań z prowadzącym badanie. Dodatkowo chorych motywowano poprzez krótkie wiadomości tekstowe i rozmowy telefoniczne. Wyniki: Po 6 miesiącach interwencji leczniczych w grupie nadciśnienia opornego odnotowano istotną zmianę w zakresie liczby kroków (17 361 ± 6815 względem 23 067 ± 7741; p < 0,005), równoważnika metabolicznego (1,325 ± 0,3 względem 1,464 ± 0,3; p = 0,001), czasu odpoczynku (1595 ± 265 względem 1458 ± 292 min; p < 0,05) i czasu snu (1278 ± 228 względem 1147 ± 270 min; p = 0,02), ocenianych na bazie 3-dniowych pomiarów akcelerometrycznych. Zwiększenie aktywności zaobserwowano również na podstawie Międzynarodowego Kwestionariusza Aktywności Fizycznej. Ponadto stwierdzono korzystne zmiany w zakresie składu ciała. Wnioski: U pacjentów z opornym nadciśnieniem tętniczym intensyfikacja aktywności ruchowej jest dobrze tolerowaną i niekosztowną interwencją terapeutyczną.

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Knowledge and attitude of community pharmacy employees towards an automatic drug substitution of generics and biosimilars

100%

Łukasik Z. M., Nowicki M.

Acta Poloniae Pharmaceutica - Drug Research

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2018

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vol. 75

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issue 5

1247-1254

EN

Rationale: In recent years many patent protections of original biopharmaceuticals have expired and biosimilar medicines are being developed and are entering the pharmaceutical market. Polish legal framework does not narrow down automatic therapeutic substitution (ATS) of biopharmaceuticals at the pharmacy level. The aim was to assess the awareness of Polish community pharmacy employees and their attitude towards ATS of generics and biosimilar medicines. Methods: A self-designed online questionnaire consisting of 27 questions addressing ATS of generics and biopharmaceuticals was created. The survey respondents were approached personally at local pharmacies, via pharmacy managers, chain pharmacy owners and Chambers of Apothecaries. Data collected was entered into descriptive statistics tool provided by the survey hosting server. Simultaneously a printed survey dedicated to patients was created to asses patterns of behaviour related to ATS. Results: According to Polish community pharmacy employees the main reason for ATS was price competitiveness, unavailability of the reference drug and patient’s wish. 7.3% of respondents have ever taken part in any drug safety monitoring program. 9.1% of pharmacy technicians and 46.8% masters of pharmacy claimed to have considerable knowledge about biosimilar drugs and evaluated biosimilars as carrying a higher risk of adverse events than generics. 17.2% would offer a substitution of a biopharmaceutical. 33.3% of patients did not tell their prescribing doctor about the ATS. Conclusions: There is strong need of establishing explicit legislation regulating ATS between reference biopharmaceuticals and biosimilars. Introduction of the framework should be simultaneously accompanied by shared trainings for medical professionals participating in the pharmacotherapy.

3

Application of graphene and newly developed amorphous alloys in current transformers for railway applications

81%

Petruk O., Nowicki M., Szewczyk R., Winiarski W.

Czasopismo Techniczne

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-

PL

Paper present practical solutions based on the utilization of graphene and amorphous alloys for construction of DC current transformer. Proposed solution is competitive as for the metrological properties and overall dimensions, and is well suited for the measurements of large currents in the railway traction. Use of amorphous alloys as magnetic materials for low-hysteresis and high- permeability cores, and development of highly sensitive graphene-based Hall effect sensors, allow for substantial improvements in the open feedback loop DC current transformers construction. In order to verify the usefulness of the developed DC current transformer, its characteristic was investigated. High linearity of the sensor is confirmed by the R-square parameter exceeding 0.99. The repeatability of the measurements was in the range of 1%. The properties of these materials raise the prospect of changes in the construction of the DC current transformers and open up the perspective of a number of innovative projects in the railway industry, in the current measurements area.

4

SOCS3 is epigenetically up-regulated in steroid resistant nephrotic children

81%

Zaorska K., Zawierucha P., Ostalska-Nowicka D., Nowicki M.

Acta Biochimica Polonica

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2016

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vol. 63

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issue 1

131-138

EN

Background. The mechanism of steroid resistance in children with the nephrotic syndrome is yet unknown. About 20% of patients demonstrate steroid unresponsiveness and progress to end stage renal disease. Aberrant SOCS3 and SOCS5 expression in steroid resistant and sensitive patients has previously been demonstrated. Here, we investigate genetic and epigenetic mechanisms of regulation of SOCS3 and SOCS5 transcription in nephrotic children. Methods. 76 patients with the nephrotic syndrome (40 steroid resistant and 36 steroid sensitive) and 33 matched controls were included in this study. We performed genotyping of a total of 34 single nucleotide polymorphisms for SOCS3 and SOCS5 promoters and evaluated their methylation status using MS-PCR and QMSP methods. Results. Steroid resistant patients had a significantly lower methylation of one region of SOCS3 promoter in comparison with steroid sensitive patients and controls (p < 0.0001). However, the relative methylation level in the steroid sensitive patients and controls differed significantly even before the first steroid dose (p = 0.001758). Other SOCS3 and SOCS5 promoter regions displayed no differences in methylation or were fully methylated/unmethylated in all study groups, showing site-specific methylation. The allele and genotype distribution for SOCS3 and SOCS5 markers did not differ statistically between the groups. Conclusions. We demonstrate an epigenetic mechanism of SOCS3 up-regulation in steroid resistant children with the nephrotic syndrome. The assessment of methylation/unmethylation of SOCS3 promoter might be an early marker for steroid responsiveness in NS patients.

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Polymorphic variants of MIF gene and prognosis in steroid therapy in children with idiopathic nephrotic syndrome

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Świerczewska M., Ostalska-Nowicka D., Kempisty B., Szczepankiewicz A., Nowicki M.

Acta Biochimica Polonica

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2014

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vol. 61

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issue 1

67-75

EN

Nephrotic syndrome (NS) is the most common reason of proteinuria in children and can be caused by the pathology of renal glomeruli. Steroid therapy is typically used in this disorder. It has been shown that MIF is a cytokine which counteracts the immunosuppressive properties of glucocorticoids. The aim of this study was looking for a correlation between MIF polymorphisms and genetic susceptibility to steroid resistance in children with INS (Idiopathic NS). Methods: The study was performed in 71 patients with INS including SRNS (steroid resistance nephrotic syndrome) (41) and SSNS (steroid sensitive nephrotic syndrome) (30) and in 30 control subjects. We employed Sanger sequencing and capillary electrophoresis. Linkage disequilibrium was made using Haploview and PHASE. Results: We didn't observe a statistical significance between SNPs detected in patients with INS and controls. Our studies revealed statistical significance for two polymorphisms: rs2070767C > T and rs2000466T > G between patients with SRNS and SSNS. The results for rs34383331T > A are close to being statistically significant. Statistical significance was revealed for CATT5/CATT6 genotype in SRNS group vs SSNS group (OR=4.604, 95%CI=1.356-15.632, p=0.0168). We found that the frequency of 5/X-CATT genotype compared with X/X-CATT genotype was significantly higher in SRNS patients vs SSNS (OR=3.167, 95%CI=1.046-9.585, p=0.0426). In linkage disequilibrium analysis we didn't show involvement in susceptibility to INS and steroid sensitive phenotype. Conclusions: Our results suggest that the role of MIF polymorphisms in the susceptibility to positive response to steroid therapy is still unresolved. It indicates that MIF may be involved in indirect and complex molecular mechanisms of steroid activity in hormone-dependent metabolic pathways in children with INS. Because of ambiguous findings, pleiotropic features of this cytokine require that more research should be undertaken.

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Molecular basis of mechanisms of steroid resistance in children with nephrotic syndrome

71%

Świerczewska M., Ostalska-Nowicka D., Kempisty B., Nowicki M., Zabel M.

Acta Biochimica Polonica

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2013

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vol. 60

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issue 3

339-344

EN

Steroid therapy, due to a wide range of anti-inflammatory properties of steroids, is a basic field of treatment in many human diseases including the nephrotic syndrome in children. However, not all patients respond positively to therapy which divides them into steroid sensitive (SS) and steroid resistance (SR) individuals. Many potential factors associated with steroid resistance have been identified so far. It seems that genetic factors associated with glucocorticoid receptor α (GRα), the structure of heterocomplex of GR as well as glycoprotein P or cytochrome P450 may play a role in the induction of glucocorticoid resistance. Here we described several of the molecular mechanisms, which can regulate glucocorticoid sensitivity and resistance. Moreover, we presented genetic defects, which can lead to various effects of treatment and, in a longer perspective, enable clinicians to individualize therapies.

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Inhibitors of N-glycosylation as a potential tool for analysis of the mechanism of action and cellular localisation of glycoprotein P

61%

Wojtowicz K., Szaflarski W., Januchowski R., Zawierucha P., Nowicki M., Zabel M.

Acta Biochimica Polonica

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2012

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vol. 59

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issue 4

445-450

EN

Multidrug resistance has for many years attracted attention of numerous investigators. Attempts have also been made to increase efficiency of anti-neoplastic therapy. For this reason, most of efforts have been devoted to analysing proteins engaged in the mechanism of multidrug resistance such as the N-glycosylated membrane protein glycoprotein P. Interestingly, glycosylation probably plays a significant role in the intracellular location and activity of modified proteins. Inhibitors of glycosylation have been demonstrated to alter the activity of glycoprotein P in various ways, depending on the cell line examined. These inhibitors markedly reduce multidrug resistance of cancer cells, thus promoting success of anti-neoplastic therapy. Here, we review the basic knowledge on N-glycosylation inhibitors, their effect on glycoprotein P and their therapeutic potential.

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Very High Concentration of D-Dimers in Portal Blood in Patients with Pancreatic Cancer

61%

Durczyński A., Szymański D., Nowicki M., Hogendorf P., Poznańska G., Strzelczyk J.

Polish Journal of Surgery

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2012

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vol. 84

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issue 10

521-525

EN

Nowadays, increasing attention has been focused on relation between increased D-dimer levels and cancer among patients without detectable thrombosis. was to measure plasma D-dimer levels in portal and peripheral blood in pancreatic cancer patients with absence of venous thromboembolism. Material and methods. Fifteen consecutive patients hospitalized in the Department of General and Transplant Surgery of Medical University in Łódź, from January to March 2012 who underwent surgery due to a pancreatic cancer were enrolled. At laparotomy, portal and peripheral blood were sampled concurrently. D-dimer and fibrinogen levels were measured. Moreover, to investigate overall coagulation function prothrombin time (PT), prothrombin index (PI), international normalized ratio (INR), thrombin time (TT), activated partial thromboplastin time (APTT), TT and APTT index were evaluated. Results. Peripheral plasma D-dimmer levels above normal range were found in 10/15 patients (66,67%), whereas D-dimer above normal values were confirmed in all portal blood samples. Mean D-dimer values were higher in portal than in peripheral blood (3279.37 vs 824.64, by 297%, p=0,025). These discrepancies were accompanied by normal limits of portal and peripheral levels of fibrinogen and comparable coagulation function indexes. Conclusion. Our preliminary study showed the close relation between activation of hemostasis, reflected by elevated D-dimers in portal blood and presence of pancreatic cancer. These data suggest that measurement of portal blood D-dimer levels may be a potentially useful technique for screening the pancreatic cancer.

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Clinical Experience in Surgical Treatment of Gastrointestinal Neuroendocrine Tumors

61%

Durczyński A., Sporny S., Szymański D., Nowicki M., Hogendorf P., Strzelczyk J.

Polish Journal of Surgery

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2010

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vol. 82

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issue 4

212-218

EN

Gastroenteropancreatic neuroendocrine tumors (GEP NET) represent heterogenous group of very rare neoplasms. Nevertheless, these tumors have been increasingly diagnosed recently. Authors present own experience with surgical treatment of gastrointestinal neuroendocrine tumors.The aim of the study was to analyse retrospectively own material of patients with gastrointestinal neuroendocrine tumors treated surgically in the Department of General and Transplant Surgery of Medical University in Łódź.Material and methods. The analysis included all patients with neuroendocrine tumors surgically treated from January 2007 to June 2009 in the Department of General and Transplant Surgery of Medical University in Łódź. The clinical patients data were obtained from medical histories, operative protocols and outcomes of final histopathological examinations. Analyzed data were as follows: age, gender, type and localization of tumor, clinical signs, results of preoperative tests and type of surgical procedure.Results. Analysis revealed that 17 patients were operated on for gastrointestinal neuroendocrine tumors between years 2007-2009 in the Department of General and Transplant Surgery. Foregut tumors (5 gastric neuroendocrine tumors and 4 pancreatic insulinomas), midgut tumors (1 neuroendocrine cancer of ascending colon, 3 hepatic neuroendocrine cancers metastases, 2 primary hepatic neuroendocrine cancers, 1 gall bladder neuroendocrine cancer) and hindgut tumors (neuroendocrine cancer of rectum) were diagnosed in nine cases (53%), in seven cases (41%) and in one case (5%), respectively. Wide range of surgeries were performed in the Department, as follows: in 2 cases right hemihepatectomy, in 3 cases extended right hemihepatectomy, in 1 case left hemihepatectomy, in 4 cases pancreatic tumor enucleation, in 2 cases gastric resection, in 3 cases gastrectomy, in 1 case right hemicolectomy and in 1 case anterior resection of the rectum. The vast majority (11/17 patients; 64%) of tumors were poorly-differentiated neuroencorine carcinomas with high grade of histological malignancy. In one case coincidence of insulinoma and nesidioblastosis was confirmed. One patient suffered from signs of neuroglycopenia with loss of consciousness and convulsion preoperatively, incorrectly diagnosed as epilepsy.Conclusions. Treatment of patients with gastrointestinal tumors is complex process and most commonly require close cooperation of various proffesional clinicians. Since asymptomatic course of disease and late stage of tumor advancement at diagnosis, technically difficult operations are often essential. Thus, surgeon who perform operations of patients with neuroendocrine tumors should be well experienced in carring out extensive surgical procedures.

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Intensyfikacja regularnej aktywności fizycznej u pacjentów z opornym nadciśnieniem tętniczym

Knowledge and attitude of community pharmacy employees towards an automatic drug substitution of generics and biosimilars

Application of graphene and newly developed amorphous alloys in current transformers for railway applications

SOCS3 is epigenetically up-regulated in steroid resistant nephrotic children

Polymorphic variants of MIF gene and prognosis in steroid therapy in children with idiopathic nephrotic syndrome

Molecular basis of mechanisms of steroid resistance in children with nephrotic syndrome

Inhibitors of N-glycosylation as a potential tool for analysis of the mechanism of action and cellular localisation of glycoprotein P

Very High Concentration of D-Dimers in Portal Blood in Patients with Pancreatic Cancer

Clinical Experience in Surgical Treatment of Gastrointestinal Neuroendocrine Tumors