Influence of diet on the risk of developing endometriosis.

Endometriosis is a hormone-dependent chronic inflammatory disease characterized by the presence of endometrium beyond the uterine cavity. The disease affects 5-15% of women of child-bearing age, 30-50% of whom suffer from infertility. Understanding the role of dietary factors in the development of endometriosis is critical to development of effective dietary instructions for prevention. Existing studies concerning nutrition and endometriosis suggest that diet is a potentially modifiable risk factor for endometriosis. Fruits and vegetables, fish oils, dairy products rich in calcium and vitamin D, and Omega-3 fatty acids are likely connected with a lower risk of developing endometriosis. Risk factors that increase the risk of endometriosis include consumption of products rich in trans-unsaturated fatty acids, consumption of fats generally, and consumption of beef and other kinds of red meat and alcohol. Currently, there are no clear correlations between par-ticular food products and the risk of endometriosis. Further research is needed in order to fully understand the influence of consumed food products on the risk of development of this disease.

Expression Profiles of Toll-Like Receptors in the Differentiation of an Infection with Borrelia burgdorferi Sensu Lato Spirochetes.

The similarity of Lyme borreliosis to other diseases and its complex pathogenesis present diagnostic and therapeutic difficulties. The changes that occur at the cellular and molecular levels after a Borrelia sp. infection still remain poorly understood. Therefore, the present study focused on the expression of TLR and TLR-signaling genes in human dermal fibroblasts in the differentiation of an infection with Borrelia burgdorferi sensu lato spirochetes. Normal human dermal fibroblasts were cultured with the spirochetes of Borrelia burgdorferi sensu stricto, Borrelia afzelii and Borrelia garinii. Total RNA was extracted from the cells using TRIzol reagent. The analysis of the expression profiles of TLRs and TLR-related genes was performed using commercially available oligonucleotide microarrays of HG-U133A. The GeneSpring 12.0 platform and significance analysis of microarrays were used for the statistical analysis of microarray data. The analyses using the oligonucleotide microarray and QRT-PCR techniques permitted to identify the genes encoding TLR4 and TLR6 as specific for infection with B. afzelii and B. burgdorferi sensu stricto. In turn, TLR3 was only characteristic for an infection with B. burgdorferi sensu stricto. There were no changes in the TLR gene expression after infection with B. garinii. Our findings confirm that Borrelia has a major effect on fibroblast gene expression. Further characterization of changes in gene expression may lead to valuable insights into the role of the toll-like receptor in the pathogenesis of Lyme disease and may provide guidelines for the development of diagnostic markers for an infection with a particular Borrelia genospecies. Moreover, this will help to identify better treatment strategies for Lyme disease.

Usefulness of magnetic resonance imaging as a prognostic variable in myelodysplastic syndromes.

BACKGROUND: Myelodysplastic syndromes are clonal disorders of stem cells, characterized by heterogeneous clinical presentation. Hematopoiesis is ineffective, characterized by abnormal differentiation, maturation and survival of hematopoietic cells. MATERIAL AND METHODS: The examinations were conducted in the Hematology Ward and the Internal Medicine Ward of the Specialist Hospital No. 1 in Bytom in the years 2006-2011. The study group included 53 patients with diagnosed myelodysplastic syndrome. The results of magnetic resonance imaging (MRI) of the spine were obtained from the medical documentation of patients. RESULTS: In the group of patients diagnosed with RT (refractory thrombocytopenia) and in the group diagnosed with RA (refractory anemia), 100% of lumbar spine images in T1- and T2- weighted sequences assessed together showed increased signal intensity. In patients diagnosed with RAEB (refractory anemia with excess blasts), MRI showed decreased signal intensity in 76.5% of subjects in the sequences analyzed together. In the group of patients with increased LDH (lactate dehydrogenase), 22 patients (55%) showed decreased signal intensity in the combined analysis of T1- and T2-weighted sequences. Among transfusion-dependent patients, 20 scans (60.6%) showed decreased signal intensity. CONCLUSIONS: As the risk category of MDS increases towards high - bad risk, decreased signal intensity is observed in lumbar spine MRI in T1- and T2-weighted images in all studied stratification scales. There is a positive correlation between decreased signal intensity in lumbar spine MRI examinations and increased LDH level in blood serum, as well as dependence on blood product transfusions, especially packed red blood cells.

Usefulness of spinal magnetic resonance imaging in patients with myelodysplastic syndromes.

BACKGROUND: Myelodysplastic syndrome is a rare, chronic hematological disease characterized by heterogeneous clinical presentations. Subtypes of myelodysplastic syndrome are characterized by different survival times and ability to transform into acute myeloid leukemia. OBJECTIVES: The objective of the study included the assessment of the relationship between the images obtained by magnetic resonance scans of lumbar spine and the clinical symptoms of the disease in patients diagnosed with myelodysplastic syndrome, as well as the assessment of the correlation of the images with the phase of transformation into acute myeloid leukemia. MATERIAL/METHODS: The study-related tests were carried out in Specialist Hospital No. 1 in Bytom between 2006 and 2011 and involved 53 patients aged 55÷77, divided into groups according to the diagnosed subtype of myelodysplastic syndrome. The study also included the prognosis of overall survival and time to transformation into AML on the basis of valid classifications. The spinal magnetic resonance scans were obtained from medical documentation. The analysis included images obtained using T1- and T2-weighted sequences in sagittal, transverse and frontal planes in all patients, images obtained using the STIR sequence from 21 patients as well as 40 images obtained after contrast administration. The statistical analysis of the results was carried out using STATISTICA software. CONCLUSIONS: The obtained results demonstrated that the magnetic resonance scans revealed statistically significant changes in the images of bone marrow in vertebral body scans; with a decrease in the intensity of MRI signals correlated with the RAEB subtype, particularly with transformation into acute myeloid leukemia as well as with the high IPSS risk score with regard to the time of survival and transformation into acute myeloid leukemia. The research-related test results indicate the importance of magnetic resonance imaging in diagnostics and the assessment of the disease dynamics.

[The role of complement factor H in the pathogenesis of Borrelia infection]. / Znaczenie czynnika H w patogenezie zakazenia kretkami Borrelia.

Complement factor H (CFH) is one of the most important negative regulators of the alternative pathway of the complement system. It is a glycoprotein belonging to the protein H family, which is synthesized mainly in the liver and is composed into a globular protein consisting of 60 amino acid domains in the serum. It shows specificity for C3b molecule of the complement system present in the serum or bound to the cell surface. It inhibits the steady formation of C3 convertase enzymes and the binding of C2 to C4b and factor B to C3b. It accelerates the decomposition of C2a into C4b and the displacement of Bb from C3b. The present paper discusses the composition, properties and functions of the complement factor and the family it belongs to. The paper focuses in particular on its role in the pathogenesis of an infection caused by the spirochetes of the Borrelia genus. Through binding CFH and other related proteins, bacteria of the Borrelia species inhibit the key effect of the alternative pathway of the complement system - the lysis of spirochete cells dependent on the complement's activation. The mechanism enables pathogens to spread in the host organism and facilitates the evolution of the disease. Discovering the immune mechanisms of the infection caused by the spirochetes of the Borrelia genus may allow for implementing a therapy blocking the binding of complement factor H early enough, apart from the standard treatment of the disease.

The role of human endogenous retroviruses in the pathogenesis of autoimmune diseases.

This paper presents a new, recently formulated theory, which concerns the etiopathological process of autoimmune diseases. This theory takes into account the existence in the human genome, since approximately 40 million years, of so-called human endogenous retroviruses (HERVs), which are transmitted to descendants "vertically" by the germ cells. It was recently established that these generally silent sequences perform some physiological roles, but occasionally become active and influence the development of some chronic diseases like diabetes, some neoplasms, chronic diseases of the nervous system (eg, sclerosis multiplex), schizophrenia and autoimmune diseases. We present a short synopsis of immunological processes involved in the pathogenesis of autoimmune diseases, such as molecular mimicry, epitope spreading and activation of the superantigen. We then focus on experimental findings related to systemic lupus erythematosus, rheumatoid arthritis, Sjögren's syndrome and some diseases of hepar and otorhinal tissues. We conclude the outline of this new model of the development of chronic diseases and indicate the conclusions important for the teaching of the basis of pathology.

[Problems of diagnosis and therapy of primary hyperparathyroidism--case report]. / Problemy rozpoznania i leczenia pierwotnej nadczynnosci przytarczyc--opis przypadku.

Primary hyperparathyroidism is systemic, polymorphic disease. Authors present a case of woman suffered from primary hyperparathyroidism misdiagnosed as disseminated neoplastic disease. There was shown a clinical picture complex, difficulties in diagnostic process, treatment and factors provided mistakes in therapy. The work lays stress on importance of routine testing of calcium in serum. It makes a contribution in diagnosis of hyperparathyroidism in symptomless or preclinical phase - before appearance metabolic and organ complications.

[Abandoning of breast cancer radical treatment--own observations]. / Zaniechanie radykalnego leczenia raka piersi--spostrzezenia wlasne.

Breast cancer is currently one of the most frequent cancers women in Poland suffer from. Incidence increases after 35 years of age and this rate remains high until the old age. Since the 1980s breast cancer has been the most frequent reason for deaths of women between 40 and 59 years of age. Breast cancer treatment is based on combination of surgical methods, the hormone therapy, chemiotherapy and radiotherapy. However treating the cause and palliative treatment may result in complications. Some patients do not give their consent to suggested medical treatment. The aim of this work is an attempt to stress complexity of breast cancer radical treatment, with patients suffering from breast cancer as an example.

[Sigmoido-vesical fistula as a cause of recurrent urinary tract infections]. / Przetoka esiczo-pecherzowa jako przyczyna nawracajacych zakazen dróg moczowych.

The authors describe a case of sigmoido-vesical fistula in 64 years old woman. The fistula probably developed as a result of complications of sigmoidal diverticulitis. The main clinical manifestation were symptoms of recurrent urinary tract infections and pneumaturia. For the diagnosis of the fistula different methods such as urography, cystography, ultrasonographic examination, colonoscopy, bacteriological urine analysis and laboratory investigations were used. The patient was qualified to surgical treatment. One-stage operation performed appeared successful.

[Evaluation of the usefulness and effectiveness of anxiolytic therapies in neoplastic diseases]. / Cena potrzeby i skutecznosci leczenia przeciwlekowego w chorobach nowotworowych.

UNLABELLED: Anxiety accompanies patients at all stages of severe somatic diseases as well in the course of diagnostic procedures. It affects significantly quality of life of these patients and their relations with their physicians. It may also induce or exacerbate wide range of somatic complaints. OBJECTIVE: Evaluation of usefulness of anxiolytic therapies in patients with diagnosed neoplastic diseases. Comparison of anti-anxiety and antidepressant effects of alprazolam and diazepam in patients treated with systemic chemotherapy. MATERIAL AND METHODS: Final analysis included 45 patients with various malignancies randomly assigned to receive alprazolam 3 x 0.5 mg or diazepam 3 x 2 mg. Anti-anxiety effects of both drugs was evaluated four times during the 21-day follow-up period at one week intervals with help of Clinical Global Impression scale (CGI), Hamilton Anxiety Rating Scale (HARS), Hospital Anxiety and Depression Scale (HADS). Analysis of these questionnaires was performed with Mann-Whitney test and Wilcoxon test. RESULTS: Statistically significant reduction of anxiety was found in both study groups. Alprazolam was proven to be significantly more effective than diazepam in reduction of anxiety (HARS, HADS) and depressive symptoms accompanying anxiety (HADS). Alprazolam vs. diazepam showed better tolerance by patients. CONCLUSIONS: Alprazolam effectively reduced anxiety in patients suffering from malignant diseases. Alprazolam was found to reduce depressive symptoms in patients with neurotic disorders whereas no effects of this kind were observed for diazepam.

[Effect of palliative chemotherapy with topoisomerase inhibitor on the quality of life and survival of patients with advanced colorectal carcinoma]. / Wplyw chemioterapii paliatywnej inhibitorem topoizomerazy na jakosc zycia i przezywalnosc chorych z zaawansowanym rakiem jelita grubego.

Among several topoisomerase I inhibitors topotecan is worth taking into account because of its little toxicity, good tolerance and quick excretion. The study compared functioning of bone marrow, liver and kidneys during and after the treatment, as well as survival period and quality of life of patients treated with topotecan and patients who underwent symptomatic treatment. 35 patients aged 43-71 of both sexes, with advanced stage of large intestine cancer (IV grade in TNM scale) were included in the study. 20 hospitalized patients were administered topotecan, topoisomerase I inhibitor, intravenously in 5-day courses (1.5 mg/m2 of body surface daily) repeated 5 times with 21-day intervals. Before the beginning of therapy and after it the following were conducted: medical check-ups as well as surveys and test research including groups of somatic and vegetative symptoms connected with the disease (based on the questionnaire QLQ-C30). 15 patients with the similar stage of the disease who had not agreed to palliative treatment with chemotherapy were treated only symptomatically. Applying antineoplastic treatment with topotecan contributes to the extension of the survival time by 4 months on average, and mortality during and after the treatment is lower than in the group of patients with the symptomatic treatment only. Antineoplastic treatment improves the quality of life and delays the disease progression. The quality of life is better until the preterminal period of the disease and enables patients maintaining motor activity and independence.