The Role of Vitamin D Metabolism Genes and Their Genomic Background in Shaping Cyclosporine A Dosage Parameters after Kidney Transplantation.

Background: Kidney transplantation is followed by immunosuppressive therapy involving calcineurin inhibitors (CNIs) such as cyclosporin A. However, long-term high CNIs doses can lead to vitamin D deficiency, and genetic variations influencing vitamin D levels can indirectly impact the necessary CNIs dosage. This study investigates the impact of genetic variations of vitamin D binding protein (DBP) rs2282679 and CYP2R1 hydroxylase rs10741657 polymorphisms on the cyclosporin A dosage in kidney transplant recipients. Additional polymorphisims of genes that are predicted to influence the pharmacogenetic profile were included. Methods: Gene polymorphisms in 177 kidney transplant recipients were analyzed using data mining techniques, including the Random Forest algorithm and Classification and Regression Trees (C&RT). The relationship between the concentration/dose (C/D) ratio of cyclosporin A and genetic profiles was assessed to determine the predictive value of DBP rs2282679 and CYP2R1 rs10741657 polymorphisms. Results: Polymorphic variants of the DBP (rs2282679) demonstrated a strong predictive value for the cyclosporin A C/D ratio in post-kidney transplantation patients. By contrast, the CYP2R1 polymorphism (rs10741657) did not show predictive significance. Additionally, the immune response genes rs231775 CTLA4 and rs1800896 IL10 were identified as predictors of cyclosporin A response, though these did not result in statistically significant differences. Conclusions:DBP rs2282679 polymorphisms can significantly predict the cyclosporin A C/D ratio, potentially enhancing the accuracy of CNI dosing. This can help identify patient groups at risk of vitamin D deficiency, ultimately improving the management of kidney transplant recipients. Understanding these genetic influences allows for more personalized and effective treatment strategies, contributing to better long-term outcomes for patients.

The Importance of the FUT2 rs602662 Polymorphism in the Risk of Cardiovascular Complications in Patients after Kidney Transplantation.

The FUT2 gene encodes an enzyme called α-1,2-fucosyltransferase, which is involved in the formation of blood group antigens AB0(H) and is also involved in the processes of vitamin B12 absorption and its transport between cells. FUT2 gene polymorphisms are associated with vitamin B12 levels in the body. Vitamin B12 deficiency associated with hyperhomocysteinemia is a major risk factor for cardiovascular diseases (CVDs), which are one of the main causes of death in patients after kidney transplantation. The aim of our study was to determine the impact of the rs602662 (G>A) polymorphism of the FUT2 gene on the functionality of transplanted kidneys and the risk of CVD in patients after kidney transplantation. The study included 402 patients treated with immunosuppression (183 patients taking cyclosporine (CsA) and 219 patients taking tacrolimus (TAC)). The analysis of the FUT2 rs602662 (G>A) polymorphism was performed using real-time PCR. Patients with CsA were more likely to be underweight (1.64% vs. 0.91%) and obese (27.87% vs. 15.98%), while those taking TAC were more likely to be of normal weight (39.27%) or overweight (43.84%). No statistically significant differences were observed comparing the mean blood pressure, both systolic and diastolic. The renal profile showed a higher median urea nitrogen concentration in patients with CsA (26.45 mg/dL (20.60-35.40) vs. 22.95 mg/dL (17.60-33.30), p = 0.004). The observed frequency of rs602662 alleles of the FUT2 gene was similar in the analyzed groups. The A allele was present in 43.7% of patients with CsA and 41.1% of those taking TAC (OR = 0.898; 95% CI: 0.678-1.189; p = 0.453). In the group with CsA, the GG genotype was present in 32.2% of patients, the GA in 48.1% and the AA in 19.7%. A similar distribution was obtained in the TAC group: GG-33.8%, GA-50.2%, and AA-16.0%. An association of genotypes containing the G allele with a higher incidence of hypertension was observed. The G allele was present in 65% of people with hypertension and in 56% of patients with normal blood pressure (p = 0.036). Moreover, the evaluation of the renal parameters showed no effect of the FUT2 polymorphism on the risk of organ rejection because the levels of creatinine, eGFR, potassium, and urea nitrogen were prognostic of successful transplantation. Our results suggest that the rs6022662 FUT2 polymorphism may influence the risk of cardiovascular diseases.

Microchimerism as Post-Transplant Marker of a Chronic Rejection Process.

The risk of losing a transplanted organ is high, and non-invasive markers to warn of this phenomenon are still being sought. We investigated the impact of post-transplant microchimerism on the function of the transplanted kidney. The study included 100 kidney transplant recipients, mostly women. All transplanted organs were from opposite-sex deceased donors. Microchimerism was assessed using multiplex PCR. Male DNA was detected in all urine samples from female recipients and in 13/56 blood samples from female kidney recipients. Female DNA was found in 31/44 urine samples from male recipients, but in none of the blood samples. Microchimerism in the urine of female recipients correlated positively with blood urea (Rs = 0.45; p = 5.84 × 10-4) and K+ ions (Rs = 0.29; p = 0.03), while microchimerism in the blood of female recipients also correlated positively with blood urea (Rs = 0. 28; p = 0.04), cystatin C (Rs = 0.31; p = 0.02) and the number of incompatible HLA alleles (Rs = 0.42; p = 0.01). A history of DGF was associated with higher urinary donor DNA concentrations in female recipients.: Post-transplant microchimerism may serve as a potential marker of chronic kidney rejection.

Age Matters: The Moderating Effect of Age on Styles and Strategies of Coping with Stress and Self-Esteem in Patients with Neoplastic Prostate Hyperplasia.

The aim of this study was to analyze coping mechanisms and their psychological aspects during the treatment of neoplastic prostate hyperplasia. We have analyzed strategies and styles of coping with stress and self-esteem of patients diagnosed with neoplastic prostate hyperplasia. A total of 126 patients were included in the study. Standardized psychological questionnaires were used to determine the type of coping strategy by using the Stress Coping Inventory MINI-COPE, while a coping style questionnaire was used to assess the type of coping style by using the Convergence Insufficiency Symptom Survey (CISS). The SES Self-Assessment Scale was used to measure the level of self-esteem. Patients using adaptive strategies of coping with stress in the form of active coping, seeking support and planning had higher self-esteem. However, the use of maladaptive coping strategies in the form of self-blame was found to cause a significant decrease in patients' self-esteem. The study has also shown the choice of a task-based coping style to positively influence one's self-esteem. An analysis related to patients' age and coping methods revealed younger patients, up to 65 years of age, using adaptive strategies of coping with stress to have a higher level of self-esteem than older patients using similar strategies. The results of this study show that older patients, despite the use of adaptation strategies, have lower self-esteem. This group of patients should receive special care both from family and medical staff. The obtained results support the implementation of holistic care for patients, using psychological interventions to improve patients' quality of life. Early psychological consultation and mobilization of patients' personal resources may allow patients to change stress coping methods towards more adaptive forms.

Medical Face Masks Do Not Affect Acid-Base Balance Yet Might Facilitate the Transmission of Staphylococcus aureus in Hospital Settings during the COVID-19 Pandemic.

INTRODUCTION: Due to the SARS-CoV-2 coronavirus pandemic, the wearing of masks has become a common phenomenon. Most of the undesirable effects of using a protective face covering are usually related to the prolonged time of its wearing, and the adverse consequences of face coverings should be considered two-fold. The aim of the study was to evaluate the rate of contamination of the three types of face coverings (surgical, N95, and FFP2 masks) with the microorganism-aerobic bacteria, yeasts, and molds-after the 3 h exposure time. The study aimed to investigate the effects of wearing FFP2 masks (KN95) on respiratory function and the acid-base balance of the human body. RESULTS: The presence of S. aureus was confirmed in both nasal carriers and non-carriers which may demonstrate the cross-contamination and spread of this bacterium via hands. S. aureus was found on external and internal surfaces of face masks of each type, and therefore could also be transmitted via hands from external sources. The 3 h exposure time is not sufficient for Gram-negative rods and mold contamination. Moreover, there were no significant differences in most of the parameters studied between the first and second examinations, both in spirometry and capillary blood gas analysis (p > 0.05).

Association of ACE2 Gene Variants with the Severity of COVID-19 Disease-A Prospective Observational Study.

The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 virus (SARS-CoV-2), has triggered an enormous scientific response. Many studies have focused on understanding the entry of the SARS-CoV-2 virus into the host cell. The angiotensin-converting enzyme-2 (ACE2) is recognized as the host receptor used by SARS-CoV-2 to enter its target cells. Recent studies suggest that ACE2 gene polymorphisms might be candidates for genetic susceptibility to SARS-CoV-2 infection. The aim of this study is to evaluate the influence of ACE2 polymorphisms on COVID-19 disease risk and severity. In our study, we confirmed that there is a statistically significant increased risk of a more severe disease course of SARS-CoV-2 infection associated with the need for hospitalization in intensive care for patients with specific polymorphisms of the ACE2 gene. The most significant correlation was found for variant ACE2 rs2285666 (AA allele, OR = 2.12, p = 0.0189) and ACE2 rs2074192 (TT allele, OR = 2.05, p = 0.0016), and for ACE2 rs4646174 (GG allele, OR = 1.93, p = 0.0016), ACE2 rs4646156 (TT allele OR = 1.71, p = 0.008) and ACE2 rs2158083 (TT allele OR = 1.84, p = 0.0025). In conclusion, our findings identify that certain ACE2 polymorphisms impact the severity of COVID-19 disease independently of other well-known risk factors.

Welfare and Self-Assessment in Patients after Aesthetic and Reconstructive Treatments.

In the last decade, there has been a noticeable increase in the interest in aesthetic and corrective surgery regardless of a patient's age. Both aesthetical and practical considerations are a motivation for patients undergoing plastic surgery. The goal of this study is to analyze dependencies between welfare, self-assessment and body self-perception in patients that qualified for plastic and aesthetic surgical procedures. The study group included 164 female patients, of whom 124 patients filled out a questionnaire before and after surgery. The questionnaire included demographic data and scales such as the Body Esteem Scale, the Rosenberg Self-Esteem Scale-SES, the Satisfaction with Life Scale-SWLS, the Flourishing Scale and the Scale of Positive and Negative Experience-SPANE. The first hypothesis concerned the subjective assessment of body self-perception after the procedure. The results of the study confirm this hypothesis-female patients after surgery rate their body self-perception higher, which indicates a positive influence of plastic and aesthetic surgery that increased in the subjective assessment of 66 examined patients. Moreover, the study revealed a higher self-assessment after procedures. On the other hand, the results indicated that younger patients had a higher body assessment, but there was no increase in self-assessment. Except for breast augmentation surgery, there was no influence on self-assessment and life satisfaction improvement after other surgical procedures. In patients up to 48 years old, after surgery, there was a significant dependence between subjective body self-assessment and all surveyed forms of welfare. In the case of patients after 48 year of age, there was a relationship between life satisfaction and body self-perception both before and after surgical treatment.

Prostate Cancer Eligible for Radical Prostatectomy: Self-Esteem of Patients and Forms of Coping with Stress.

The purpose of this study was to analyze the strategies and styles of coping with stress and self-esteem in patients diagnosed with prostate cancer. One hundred and five patients with prostate cancer participated in the study. Coping strategies were assessed with the Mini-Cope questionnaire, coping styles were assessed with the Coping Inventory for Stressful Situations, and self-esteem was assessed with the Rosenberg Self-Esteem Scale. Patients' self-esteem and stress coping styles and strategies were analyzed using a Pearson correlation analysis. A stepwise linear regression analysis was performed to determine the predictors of self-esteem. The self-esteem level was positively related to the task-focused style (r = 0.228) and negatively related to the emotion-focused style (r = −0.329). The self-esteem level was significantly positively related to the strategies of active coping (r = 0.358), planning (r = 0.355), and seeking emotional support (r = 0.319) and was negatively related to self-blaming (r = −0.448) and to substance use (r = −0.301). The predictors of self-esteem level were: the strategies of self-blaming, planning, and the support-seeking dimension (F(3, 95) = 17.65; p < 0.001), explaining 33.8% of the variability in subjects' self-esteem level. The moderating effect of age occurred in patients up to 65 years; it was statistically insignificant in patients older than 65 years. Replacement of the self-blame strategy and the emotion-focused style may lead to higher self-esteem of patients. The level of self-esteem can predict the strategies of self-blaming, planning, and the dimension of seeking support. For patients up to 65 years, psychological support should include reinforcement of adaptive forms of coping.

Rapid Access in Donation After Circulatory Death (DCD): The Single-Center Experience With a Classic Pathway in Uncontrolled DCD Algorithm.

BACKGROUND: In Poland, 95% of organs for transplantation come from donation after brain death (DBD). In 2010, Poland officially joined the European countries in which donation after circulatory death is accepted by law. Currently, the Pomeranian Medical University Transplant Center is the only active location for uncontrolled donation after circulatory death (uDCD) in Poland. To estimate the results of uDCD kidney transplantation with a classical approach to organ recovery, we analyzed data from an early phase of uDCD program. METHODS: Prospective observation of uDCD kidney allografts (group 1; n = 8) compared with DBD kidney allografts (group 2; n = 30). The organ recovery protocol was set up on rapid abdominal access without regional perfusion before procurement. RESULTS: The organs recovered from uDCD during a 24-month period increased the volume of kidneys transplanted at the center by 9.2%. Delayed graft function was diagnosed in 100% vs 46% of allografts (P = .03), respectively. Nevertheless, early posttransplant follow-up did not reveal any graft loss or recipient death cases in the DCD group. After 12 months of follow-up, the mean glomerular filtration rate was 44.5 vs 57.9 mL/min (P < .02), respectively. Crucial factors for acceptable results of uDCD are strict pretransplant assessment of recovered organs and efficient coordination of the transplant team. CONCLUSIONS: Conservative recovery protocol in uDCD under strict prerequisites is feasible to consider in the organ procurement pathway. Preliminary results provide space for an increase in the organ donor pool.

Irritable Bowel Syndrome Prevalence among Participants of Woodstock Rock Festival in Poland Based on Rome IV Criteria Questionnaire.

BACKGROUND: Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disorder (FGID), in which etiology and pathogenesis are not fully explored. There is an ongoing need for more population studies adhering to new ROME IV criteria. In the current study, which follows our previous investigation among participants of the Woodstock Rock Festival in Poland, we aimed to evaluate the prevalence of IBS and its relation to age, gender, education, and IBS type. METHODS: Rome IV criteria questionnaire was used to assess abdominal complaints of 386 participants of the Woodstock Rock festival 2018. RESULTS: Analyzed data revealed that Rome IV criteria were met by 42 participants (11.41%), 11 men and 31 women (p = 0.0028), with following types of IBS: IBS-M (mixed form) 55%, IBS-D (with diarrhea) 33%, IBS-U (unclassified) 10%, IBS-C (with constipation) 2%. No statistically significant correlation between IBS prevalence and age, gender, or education (p > 0.05) was found. CONCLUSIONS: The prevalence of IBS among major rock festival participants in Poland was high. Women met the criteria more often than men, which is consistent with global epidemiology for many years. Among participants of the Woodstock Rock Festival, the most frequent subtype was IBS-M, the rarest-IBS-C. There is a need of conducting cohort studies in bigger groups in our population.