Serum selenium levels predict survival after breast cancer.

BACKGROUND: Studies have reported an inverse relationship between serum selenium levels and cancer incidence, but the impact of low serum selenium status on survival after a diagnosis of breast cancer has not been established. METHODS: We obtained a blood sample from 546 women diagnosed with a first primary invasive breast cancer between 2008 and 2015 in the region of Szczecin, Poland. Blood was collected after diagnosis, but prior to treatment. Serum selenium was quantified by mass spectroscopy and each patient was assigned to one of four categories (quartiles) based on the distribution in the entire cohort. Patients were followed from diagnosis to death over a mean follow-up of 3.8 years. Vital status was obtained by linkage to the Polish National Death Registry. RESULTS: The 5-year overall actuarial survival was 68.1% for women in the lowest (< 64.4 µg/L) and 82.5% for those in the highest (> 81.0 µg/L) quartile of serum selenium. In an adjusted analysis, the hazard ratio for death was 2.49 (95%CI 1.53-4.04; P = 0.0002) for patients in the lowest quartile of serum selenium, compared to those in all other quartiles. The effect of low selenium on breast cancer-specific mortality was stronger for women who were past smokers (HR 6.03; 95%CI 1.96-18.6; P = 0.0002). CONCLUSIONS: This study suggests that a selenium level in excess of 64.4 µg//L might be beneficial for women undergoing treatment for breast cancer and that selenium supplementation to achieve this level may favorably impact the outcome. Further studies are needed to confirm this association and to evaluate the impact of selenium supplementation on breast cancer survival among women with low post-diagnostic selenium levels.

Molecular typing of Staphylococcus aureus based on PCR-RFLP of coa gene and RAPD analysis.

The aim of this study was molecular identification of S. aureus strains isolated from mastitic milk samples and establishing the genetic relationship between strains isolated from cows belonging to the same herd. In all 43 isolated strains the gap gene (930 bp) was amplified, which enabled their affiliation to the Staphylococcus genus to be established. PCR-RFLP with AluI endonuclease of the gap gene as well as nuc (450 bp) and coa (1130 bp) gene amplification allowed precise S. aureus species identification. One hundred percent of the genetic relationship between strains was established via RAPD-PCR and coa-typing.

Mechanisms of resistance to antimicrobial drugs in pathogenic Gram-positive cocci.

Many species of Gram-positive cocci are pathogenic. The most important are staphylococci, streptococci, and enterococci. Widespread usage of antibiotics was the main cause for the appearance and spread of resistance to almost all antimicrobials. The occurrence, mechanisms, and genetic background of resistance to antimicrobial drugs other than beta-lactams and glycopeptides among pathogenic staphylococci, streptococci, and enterococci are discussed in the text. Well-established agents (such as macrolides, lincosamides, streptogramins, aminoglycosides, quinolones, mupirocin, chloramphenicol) as well as new agents (linezolid, daptomycin, quinupristine/dalfopristine, ratapamulin, tigecycline, iclaprim and new generations of quinolones) are considered.

Factors affecting dystocia in cattle.

The paper reviews the various factors affecting dystocia in cattle. It is based mainly on the recent studies found in the literature of the subject but refers occasionally to some older papers as well. The factors are grouped into four main categories: direct factors, phenotypic factors related to calf and cow, non-genetic and genetic factors. The first group includes malpresentations and uterine torsion. The second one includes: calf birth weight, multiple calvings, perinatal mortality, cow pelvic area, cow body weight and body condition at calving, gestation length. The non-genetic factors are: cow age and parity, year and season of calving, place of calving, maintenance practises, disorders, calf sex and nutrition. Other non-genetic factors are the level of hormones in the periparturient period, in vitro production of embryos and embryo cloning. Finally, the genotypes of cow, bull and calf, inbreeding, muscular hypertrophy, selection and quantitative trait loci form the fourth group of genetic factors.

Mechanisms of the resistance and tolerance to beta-lactam and glycopeptide antibiotics in pathogenic gram-positive cocci.

Beta-lactams are the most frequently used antimicrobials in combating infections. In the case of gram-positive bacteria resistant to beta-lactams, glycopeptides are the first choice. The occurrence, mechanisms and genetic background of the resistance of pathogenic staphylococci, streptococci and enterococci to beta-lactam and glycopeptide antibiotics were discussed. The resistances to well-established antimicrobials, as well as new agents (ceftobiprole, oritavancin, telavancin, dalbavancin) were taken into consideration in the text.

Pediatric environmental medicine in Eastern Central Europe.

Pediatric environmental medicine in Central Eastern Europe needs support and development on national, institutional and individual basis. This situation is quantitatively, but not fundamentally different from what is to be found in Central Europe.

Effect of sulodexide on albuminuria, NAG excretion and glomerular filtration response to dopamine in diabetic patients.

BACKGROUND: Albuminuria is the best and most readily available marker for glomerular damage and progressive renal function loss in patients with diabetic nephropathy. Recently, administration of the oral glycosaminoglycan sulodexide (a mixture of 80% fast-moving heparin and 20% dermatan sulphate) was shown to effectively decrease albumin excretion rate in diabetics with nephropathy. AIMS: To evaluate whether the hypoalbuminuric effect of sulodexide is associated with improvement of the renal vascular or tubule function. METHODS: Forty-five type 1 diabetic patients, affected by diabetic nephropathy with albuminuria for at least 5 years, were randomly allocated to sulodexide or untreated. Those allocated to sulodexide were given 100 mg of sulodexide daily for 120 days. Renal vascular function (DIR) and N-acetyl-beta-D-glucosaminidase (NAG) excretion were estimated before and at the end of the study, the former in thesulodexide group only. DIR was measured as two Cr(cl) lasting 120 min (before and during 2 mug/kg b.w. i.v. dopamine). RESULTS: The analysis of trends during the study demonstrated a marked reduction of albuminuria in the sulodexide group (from 126.1 +/- 15.41 to 93.6 +/- 13.7 mg/day). DIR rose from 13.2 +/- 2.1% to 15.44 +/- 1.9% (relative increase: +16.9%), and NAG excretion showed a decreasing trend decreased in the sulodexide group only (from 5.1 +/- 0.62 to 4.7 +/- 0.40 U/g(creat)). CONCLUSION: The findings presented in this study indicate for the first time that orally available sulodexide may favorably affect the renal vascular function in type 1 diabetic patients with nephropathy and microalbuminuria. The effect of sulodexide on NAG is strongly influenced by the baseline NAG values, with a significant NAG reduction in the patients with the highest baseline NAG values.

[Does macular hole formation have a hormonal cause?]. / Czy powstawanie otworu plamki ma uwarunkowania hormonalne?

PURPOSE: To establish the degree of supposed hormonal deficiency in estriadol (E2), gonadotrophins (LH, FSH), growth hormone (GH), insuline-like growth factor 1 (IGF-1) and to assess calcic-phosphatic metabolism in women with idiopathic macula holes as compared to (age-matched) controls. MATERIAL AND METHODS: In 16 female patients aged 65-72, blood E2, LH, FSH, IGF-1 were determined. Serum and 24 h urine excretion calcium and phosphates as well as serum alkaline phosphatase activity were taken as markers of Ca/P metabolism. Bone densitometry was performed in all. RESULTS: Mean actual serum hormone levels were: E2 < 15 pg/ml, LH--31 U/l, FSH--49 U/l, GH--0.1 ng/ml, IGF1--59 ng/ml. The markers of mineral metabolism did not show any abnormality: serum Ca--5.0 mEq/l, P--4.1 mg%, alkaline phosphatase 111 U/l, 24 h urine excretion Ca--121 mg/24 h, P--610 mg/24 h. Mean bone L2-L4 density fell within normal limits: 81% (z = -1.91). CONCLUSIONS: In postmenopausal women with idiopathic macular holes, serum E2, LH, FSH bone metabolic markers and bone density are comparable to those found in women (of the same age group) free of macular holes. Women with macular holes are characterized by lower GH and IGF-1, which prompts further study.

Results of the health survey of a population living in a vicinity of a large waste site (Warsaw, Poland).

Although attracting rapidly increasing attention from the public, the health impact of environmental exposures related to the operation of waste dumping sites is a relatively new issue in Poland. However, the problem cannot be neglected in light of the fact that environmental impact assessment in selected sites revealed the lack of sufficient documentation concerning quantity and quality of dumped materials and poor technological management of the sites. The paper describes the results of health survey performed in a vicinity of a country's largest municipal waste site. Although the study came across methodological obstacles involving low participation and difficult to estimate representativeness of the examined group its findings obtained in 393 adults and 188 children and the results of internal comparisons revealed some interesting observations. Three "exposure-classification" variables were used in data analysis (geographical location, distance, "waste traffic" intensity) and health status was examined by means of self- and physician-administered questionnaire, physical examination and routine laboratory analyses. Relationship, although weak, of subjective symptoms and objective findings with the place of residence vis-a-vis the waste site location suggests that potential health effects of waste site-related environmental exposures might include psychological problems, digestive tract disorders and respiratory disorders as well as allergic symptoms. An intriguing observation concerning pregnancy-related health outcomes was made. The exact role of environmental determinants in this respect remains unclear and should be addressed by specific environmental epidemiological and toxicological studies. The findings as well as subjects' concern about health consequences of exposures to waste-related pollution (paralleled by subjective perception of impaired health) justify further investigations and public health initiatives including environmental impact assessment and health monitoring activities targeting populations living in a vicinity of waste sites in Poland.

[Pars plana vitrectomy in the treatment of endophthalmitis]. / Witrektomia w leczeniu zapalen wnetrza galki ocznej.

PURPOSE: To assess the effectiveness of vitrectomy in the treatment of patients with endophthalmitis. MATERIAL AND METHODS: Ten patients with endophthalmitis were qualified for treatment with vitrectomy via pars plana of a cilliary body. Endophthalmitis was diagnosed as resulting from previous: ECCE + I in 3 patients, penetrating bulb injury in 3 patients, penetrating keratoplasty in 1 patient; 3 other patients suffered from endogenous endophthalmitis. In all patients prior to surgical procedure samples of the vitreous were collected for bacteriology and mycology tests. RESULTS: In 9 cases the surgery was followed by intravitreal administration of 1 or 2 antibiotics. In 1 case an antibiotic was added to the infusion solution. In all patients the following data were analyzed together with the result of a surgical procedure: cause of endophthalmitis, visual acquity directly before and after the procedure and over the follow-up period (from 6 months to 3 years), time delay between the onset of endophthalmitis and vitrectomy performed. CONCLUSION: Vitrectomy performed via pars plana of a cilliary body is an effective method of treatment in cases of endophthalmitis. In patients with endophthalmitis early performed vitrectomy, followed by adequate adjuvant pharmacotherapy determine the chances for good postoperative prognosis.

[The condition of the posterior capsule in pseudophakic retinal detachment]. / Stan torebki tylnej a odwarstwienie siatkówki w pseudofakii.

PURPOSE: Analysis of condition of posterior capsule in pseudophakic retinal detachment. MATERIAL AND METHODS: 37 pseudophakic eyes of 35 patients with retinal detachment were examined. The condition of posterior capsule and the time when retinal detachment was observed were analysed. CONCLUSION: Disruption of the posterior capsule as a complication of cataract surgery was associated with a significant elevated risk of retinal detachment. Uncomplicated posterior capsule prevented acid from vitreous delayed retinal detachment, but is not eliminated, especially in risk factor cases.

[Surgical decompression of the orbit in a case of post-traumatic retrobulbar hematoma]. / Chirurgiczne odbarczenie oczodolu w przypadku pourazowego krwiaka pozagalkowego.

The authors present a case of 34-years-old man with retrobulbar hematoma caused by blunt injury accompanied by partial palsy of the oculomotor nerve and ischemia of the optic nerve and retina. Fractures of the orbit were excluded using computer tomography. Surgical decompression of the orbit was performed. The authors obtained quick and marked improvement with normal visual acuity and limitation of adduction.

Application of arylosulfonic acids in analysis of antihypertensive drugs.

Suitability of four arylosulfonic acids and their sodium salts to form derivatives with hypotensive drugs were studied. New crystalline arylosulfonates of todralazine, hydralazine and dihydralazine were obtained. Physico-chemical properties of the obtained arylosulfonates were tested. Reagents mentioned above were also used in analysis of these drugs.

[Current views on the etiopathogenesis of proliferative vitreoretinopathy]. / Wspólczesne poglady na etiopatogeneze witreoretinopatii proliferacyjnej.

Review of current knowledge concerning the etiology and factors associated with development and clinical course of PVR is presented. Special attention was paid to the role of blood-retinal barrier break and iatrogenic factors. The new conception that PVR could be compared with "wound healing" reaction, in which autoimmunological mechanisms were involved is also discussed.

[Miragel in surgery of retinal detachment]. / Miragel w operacyjnym leczeniu odwarstwienia siatkówki.

The authors presented results of the surgical treatment of 33 patients with retinal detachment, in whom Miragel implants were used for scleral buckling. The studies have confirmed that Miragel is a very good material for retinal detachment surgery and its application on a larger scale is recommended.

[Intraocular tamponade with SF6 gas in the treatment of selected cases of retinal detachment]. / Tamponada wewnatrzgalkowa gazem SF6 w leczeniu wybranych przypadków odwarstwien siatkówki.

The aim of this paper is to present the results of the endotamponade with SF6 gas in the treatment of 19 patients with retinal detachment. The cases selected for the surgery were characterised by the retinal tear situated in the upper part of the fundus of the eye or in the posterior pole with no symptoms of PVR phase C and D and vitreo-retinal traction. The indications for endotamponade, the causes of failures and the complications connected with this kind of surgery were discussed.

[Prognostic value of treatment trials used during the preoperative period in patients with primary retinal detachment]. / Wartosc prognostyczna próby lezenia stosowanej w okresie przedoperacyjnym u chorych z pierwotnym odwarstwieniem siatkówki.

Analysed are the results of surgical treatment and the methods applied in patients with primary retinal detachment who have been placed in recumbent position in the preoperative period. It was demonstrated that in all the cases in which after staying in bed one could observe a full or partial retinal re-apposition--a relatively simple and sparing operation was sufficient for a lasting cure. The presented results show that a successful outcome of the reclining position trial constitutes one of the favourable prognostic factors for the success of the surgical intervention.

[Clinical and histopathological observations of retinal sutures. Preliminary report]. / Kliniczne i histopatologiczne obserwacje szwów siatkówkowych. Doniesienie wstepne.

One of the therapeutical methods in the great hole and ora serrata retinal detachment are the retino-scleral sutures. The study evaluates the tolerance of this type of stitches. Experimental investigations have been performed in rabbits with sutures of Ethilon 8-0 or chromic collagen 8-0 put through the sclera. Both segments--the anterior and posterior one have been taken under consideration. The eye have been enucleated on the 1st, 2d, 7th, 14th and 60th day after surgery and evaluated macroscopically. The specimen from the spot of stitching have been executed after fixation in formaline. Clinical observations, macroscopic evaluation of the enucleated eyes and results of the histopathological examination showed good tolerance of the retinal stitches through the tissue of the rabbits eye and indicate the possibility of a clinical utilization of this method.

[Temporal arteritis]. / Arteritis temporalis.

Presented is a case of a 74 years old patient whose ailment was diagnosed as Horton's disease (temporal arteritis) on the basis of general clinical symptoms (constant headache, sclerosis of the temporal artery, anorexia and sleeplessness) and ocular signs (poor visual acuity and pale papilloedema).

[Treatment results of diabetes type 2 with obesity in the elderly]. / Wyniki leczenia cukrzycy typu 2 z otyloscia w wieku podeszlym.

The aim of these investigations were the estimation of methods and results of treatment obese diabetics over 65 years and presentation of the most common mistakes of treatment. Two groups of elderly obese diabetics type 2 were compared. The first group involved the patients who kept closely to a low caloric diet and they achieved a decrease of their body mass. The second group consisted of the patients who failed to keep to a low caloric diet and their body mass after treatment either remained the same or increased. In almost all the cases of the first group a significant improvement was observed. The improvement manifested itself by the decrease of glycemia and glycosuria as well as by a lower demand for hypoglycemic drugs. In the second group the decrease of hypoglycemic drugs was not possible and in many cases the increase of hypoglycemic drug doses was necessary. The body mass reduction in obese diabetics also those of advanced years is a significant factor in the process of treatment and it is equally important to pharmacotherapy.