IgA vasculitis after COVID-19: a case-based review.

IgA-associated vasculitis (IgAV) known as Henoch - Schönlein purpura (HSP) disease is an inflammatory disorder of small blood vessels. It's the most common type of systemic vasculitis in children which can be associated with the inflammatory process following infections. IgA vasculitis is a rare and poorly understood systemic vasculitis in adults. Coronavirus disease 2019 (COVID-19) has been associated with HSP in both adults and children. A 58-year-old woman was diagnosed with HSP, fulfilling the clinical criteria: palpable purpura, arthritis, hematuria. The disclosure of the HSP disease was preceded by a infection of the respiratory tract. COVID-19 infection was confirmed via the presence of IgM and IgG antibodies. This case indicates the possible role of SARS-CoV-2 in the development of HSP. The clinical course of IgAV in adults appears to be different from pediatric IgAV, especially due to higher risk of renal complications. Symptoms of the disease quickly resolved with low-dose of steroids.

Relationship between concentration of air pollutants and frequency of hospitalisations due to respiratory diseases.

INTRODUCTION AND OBJECTIVE: Smog, which contains fine dusts, non-metal oxides, metals and organic compounds can have irritating, allergenic and immunomodulatory effects leading to the development of respiratory diseases and their exacerbations. The aim of the study was to search for a relationship between concentrations of air pollutants and the frequency of hospitalizations due to exacerbation of asthma, chronic obstructive pulmonary disease, or abnormalitis in breathing. MATERIAL AND METHODS: Hospital admission data was accessed from the hospital digital in-formation system. From the publicly available database of the Chief Inspectorate for Environmental Protection, data concerning the concentrations of pollutants, such as PM2.5 and PM10, sulphur oxide IV (SO2), nitric oxide IV (NO2), carbon monoxide II (CO), benzene and ozone (O3), measured daily with hourly accuracy was used. The results of the average concentrations of air pollutants were compared with the rates of hospitalization in the corresponding time intervals. RESULTS: A number of statistically significant correlations were shown indicating the role of increased concentrations of each of the tested contaminants in the frequency of hospitalizations. In particular, strongly positive correlations were shown between the frequency of hospitalizations due to COPD and PM2.5 and PM10, asthma with benzene and NO2, and for respiratory disorders in general with benzene, CO and SO2. CONCLUSIONS: The results indicate that air pollution can be a significant modifiable risk factor for exacerbations of respiratory diseases and therefore its avoidance plays an important role in primary prevention.

What Remains up to 7 Months after Severe and Moderate Pneumonia in Non-Vaccinated Patients with Long COVID? Results of a CT Study.

BACKGROUND: There is a growing evidence of long-lasting lung changes after COVID-19. Our aim was to assess the degree of lung injury and evaluate the recovery process of 4-7-month-non-vaccinated convalescent patients discharged from hospital after moderate and severe COVID-19 pneumonia, who presented with symptoms of long-COVID. METHODS: On control lung CT after mean 5-month recovery period, we classified and determined the prevalence of residual radiological abnormalities in 39 symptomatic patients. To assess the advancement of the persisting changes we used the total severity score (TSS) and the chest CT score and then correlated the results with clinical data. RESULTS AND CONCLUSIONS: On follow-up CT images, 94.9% of patients showed persistent radiological abnormalities. The most frequent changes were ground-glass opacities (74.4%), reticular pattern (64.1%), fibrotic changes (53.8%), nodules (33.3%), bronchiectasis (15.4%), vascular enlargement (10.3%), and cavitation (5.1%). The median TSS score was 4.1 points (interquartile range 3), whereas the median of the chest CT score 5.4 points (interquartile range of 4.5). No significant differences were observed between sex subgroups and between the severe and moderate course groups. There were no association between both CT scores and the severity of the initial disease, indicating that, mean 5 months after the disease, pulmonary abnormalities reduced to a similar stage in both subgroups of severity.

Is the needle still needed? Relationship between laboratory features of pleural effusion and results of lung CT examinations in patients with pneumonia and lung cancer.

INTRODUCTION AND OBJECTIVE: Thoracocentesis is an invasive procedure routinely performed in the diagnosis of causes for the presence of pathological fluid in the pleural cavity. In many patients, a computed tomography scanning (CT) is also performed to diagnose the cause of the presence of fluid in the pleural cavity. The diagnostic value of CT is particularly high in situations in which performing thoracocenthesis could be associated with an increased risk of complications. The aim other study was to assess the relationship between the objective radiological features and the results of laboratory tests of fluid collected by thoracocenthesis in patients with pneumo-nias (n=18) and lung cancer (n=35). MATERIAL AND METHODS: The examined group consisted of the patients with pneumonia (n=18) and lung cancer (n=35) which resulted in the presence of fluid in the pleural cavity. In the patients thoracocentesis, CT lung scanning was also performed, according to the medical indications. Three scans with the greatest amount of fluid were identified, and the mean density of the fluid expressed in Hounsfield units was calculated within the area. These calculations were compared with the results of laboratory fluid tests. RESULTS: The maximum number of Hounsfield units (HU) was significantly lower in the group of lung cancer patients, compared to those diagnosed with pneumonia (74.3% sensi-tivity and 55.6% specificity). The pH of pleural fluid was significantly lower in patients with lung cancer, compared to those with pneumonia (74.3% sensitivity and 66.7% specificity). CONCLUSIONS: According to the results, radiological differentiation of pneumonia and lung cancer resulting in pleural effusion, to some extent is possible; however, the needle is still needed.

Chemical composition of extracts from leaves, stems and roots of wasabi (Eutrema japonicum) and their anti-cancer, anti-inflammatory and anti-microbial activities.

The purpose of our study was to evaluate the composition of the extracts obtained from the roots and leaves of Eutrema japonicum cultivated in Poland. For this purpose, LC-DAD-IT-MS and LC-Q-TOF-MS analyses were used. The results revealed the presence of forty-two constituents comprising glycosinolates, phenylpropanoid glycosides, flavone glycosides, hydroxycinnamic acids, and other compounds. Then, the resultant extracts were subjected to an assessment of the potential cytotoxic effect on human colon adenocarcinoma cells, the effect on the growth of probiotic and intestinal pathogenic strains, as well as their anti-inflammatory activity. It was demonstrated that 60% ethanol extract from the biennial roots (WR2) had the strongest anti-inflammatory, antibacterial, and cytotoxic activities compared to the other samples. Our results suggest that extracts from E. japonicum may be considered as a promising compound for the production of health-promoting supplements.

Giant haematoma of the posterior compartment of thigh in a patient with coronavirus disease 19 pneumonia and pulmonary embolism - Case Report.

Introduction. During the Coronavirus-19 (Covid-19) pandemic, a significant increase in the frequency of complications in the form of venous thrombosis was observed. However, there is also the other side of the coin - an increase in the tendency to bleeding in the course of COVID19. Case Report. We present the case of a patient hospitalised in the COVID-19 Isolation Ward due to severe pneumonia in the course of SARS-CoV2 infection. She developed respiratory failure requiring a non-invasive mechanical ventilation. In addition, pulmonary embolism was diagnosed, the treatment with low molecule heparin was initiated. Soon, the patient developed a huge haematoma of the posterior compartment of the thigh causing deformation and dysfunction of the limb and resulting with acute haemorrhagic anaemia. Conclusion. Our article is a contribution to the discussion on the need to pay attention to the possibility of haemorrhagic complications in the course of anticoagulant treatment due to venous thrombosis in COVID-19 patients.

Residential Radon Exposure in Patients with Advanced Lung Cancer in Lublin Region, Poland.

Exposure to radon is the second most common factor causing lung cancer in smokers and the first among non-smokers. We aimed to measure the impact of the radon exposure on patients with different histological types of advanced lung cancer. The measurement of radon exposure was performed in 102 patients with lung cancer in stage 3B or higher (Poland). There were 78.4% of patients with non-small cell carcinoma and 21.6% of patients with small cell carcinoma. One month radon exposure measurement was performed with trace detectors in order to control whether high radon concentrations (>800 Bq/m3) were found in the homes of patients with cancer diagnosed. Results of the determinations were then compared with the representation of the most common types of lung cancer in the study population. In the analyzed group, the average concentration of radon during the exposure of the detector in the residential premises of the respondents accounted for 69.0 Bq/m3 [37.0−117.0] and had no statistically significant effect on the type of lung cancer developed in patients. The lack of statistical significance may result from the small study group and the accompanying exposure to other harmful components. As the incidence of lung adenocarcinoma is increasing and exposure to tobacco smoke is decreasing, the search for other modifiable causes of lung cancer should be the task in the future.

LC-ESI-MS/MS Identification of Biologically Active Phenolics in Different Extracts of Alchemilla acutiloba Opiz.

Liquid chromatography electrospray ionization tandem mass spectrometric (LC-ESI-MS/MS) qualitative and quantitative analysis of different extracts from the aerial parts and roots of Alchemilla acutiloba led to the identification of phenolic acids and flavonoids. To the best of our knowledge, isorhamnetin 3-glucoside, kaempferol 3-rutinoside, narcissoside, naringenin 7-glucoside, 3-O-methylquercetin, naringenin, eriodictyol, rhamnetin, and isorhamnetin were described for the first time in Alchemilla genus. In addition, the antioxidant, anti-inflammatory and cytotoxic activity of all extracts were evaluated. The results clearly showed that among analyzed extracts, the butanol extract of the aerial parts exhibited the highest biological activity comparable with the positive controls used.

Acute liver injury in the course of COVID-19.

Although coronavirus disease 19 (COVID-19) most often affects the respiratory system, in the course of this disease, dysfunction of many other organs may also develop. The case is presented of a female patient, treated for a long time due to chronic obstructive pulmonary disease, complicated by chronic complete respiratory failure, and who was undergoing non-invasive mechanical ventilation at home. She was admitted to the Pneumonology Department due to exacerbation of the symptoms of her underlying disease. Several tests for SARS-CoV2 infection gave a negative result. During the patient's stay in the clinic, a rapid increase was observed in symptoms of respiratory failure, heart failure, and laboratory signs of acute liver damage. The next PCR test result proved to be positive. In addition to the case report, the possible impact of SARS-CoV2 infection on liver damage is also also discussed, along with a literature review on this topic.

Flavonoid and Phenolic Acids Content and In Vitro Study of the Potential Anti-Aging Properties of Eutrema japonicum (Miq.) Koidz Cultivated in Wasabi Farm Poland.

Skin aging is a natural, unavoidable, and complex process caused by oxidative stress. As a consequence, it leads to an increase in the activation of extracellular matrix disruption enzymes and DNA damage. The search for natural sources that inhibit these mechanisms can be a good approach to prevent skin aging. The purpose of our study was to evaluate the composition of flavonoids and phenolic acids in the extracts obtained from the flowers, roots, and leaves of Eutrema japonicum cultivated in Poland. Then, the resultant extracts were subjected to an assessment of antioxidant, anti-collagenase, anti-elastase, anti-hyaluronidase, antibacterial, and cytotoxic properties. It was demonstrated that the extract from the flowers had the highest content of flavonoid glycosides (17.15 mg/g DE). This extract showed the greatest antioxidant, anti-collagenase, anti-elastase, and anti-hyaluronidase activities compared to the other samples. Importantly, the collagenase inhibitory activity of this extract (93.34% ± 0.77%) was better than that of positive control epigallocatechin gallate (88.49% ± 0.45%). An undeniable advantage of this extract was also to possess moderate antibacterial properties and no cytotoxicity towards normal human skin fibroblasts. Our results suggest that extracts from E. japonicum flowers may be considered as a promising antiaging compound for applications in cosmetic formulations.

Various Forms of Tuberculosis in Patients with Inflammatory Bowel Diseases Treated with Biological Agents.

Although there are undeniable advantages of treatment of the inflammatory bowel diseases, Crohn's disease, and ulcerative colitis, with biological agents, the increased susceptibility to tuberculosis should not be ignored. Tuberculosis is an infectious disease caused by the Mycobacterium tuberculosis complex which includes M. tuberculosis, M. bovis, and M. africanum. Primary tuberculosis is uncommon in the setting of inflammatory bowel disease: reactivation of latent tuberculosis is of greater concern. Consequently, latent infection should be excluded in patients who qualify for immunosuppressive treatments. Apart from the review of the literature, this article also presents three cases of different patterns of tuberculosis that occurred during treatment with infliximab, adalimumab, or vedolizumab. The first case reports a case of tuberculosis presenting as right middle lobe pneumonia. The second case featured miliary tuberculosis of the lungs with involvement of the mediastinal lymph nodes, liver, and spleen. The third patient developed a tuberculoma of the right parietal lobe and tuberculous meningitis. It is important to reiterate that every patient qualifying for a biologic agent should undergo testing to accurately identify latent tuberculosis, as well as precise monitoring for the possible development of one of the various forms or patterns of tuberculosis during treatment.

Radon-The Element of Risk. The Impact of Radon Exposure on Human Health.

Lung cancer is a heterogeneous group of diseases with multifactorial aetiology. Smoking has been undeniably recognized as the main aetiological factor in lung cancer, but it should be emphasized that it is not the only factor. It is worth noting that a number of nonsmokers also develop this disease. Radon exposure is the second greatest risk factor for lung cancer among smokers-after smoking-and the first one for nonsmokers. The knowledge about this element amongst specialist oncologists and pulmonologists seems to be very superficial. We discuss the impact of radon on human health, with particular emphasis on respiratory diseases, including lung cancer. A better understanding of the problem will increase the chance of reducing the impact of radon exposure on public health and may contribute to more effective prevention of a number of lung diseases.

Phenolic Composition and Skin-Related Properties of the Aerial Parts Extract of Different Hemerocallis Cultivars.

Hemerocallis plants are important vegetables with nutritional and health value, especially in eastern Asia, where they have been used as medicines to cure disease such as depression and inflammation for thousands of years. The present study concerns the determination of flavonoids and phenolic acids, as well as antioxidant, anti-collagenase, anti-elastase, anti-tyrosinase and antimicrobial properties of taxa cultivated in Poland. For chemical composition estimation, LC-ESI-MS/MS analysis and spectrophotometric assays were performed. The results show the presence of sixteen compounds in all analyzed species. Among the investigated cultivars, it was found that H. "Chicago Apache" and H. fulva var. kwanso have the highest total phenolic acid and flavonoid content. The most abundant compounds in all analyzed extracts were chlorogenic acid (209.8 to 1010.0 µg/g of DE) and quercetin-3-O-rutinoside (114.7 to 1049.7 µg/g of DE). The studied extracts exhibited moderate to high skin-related activities. These properties were correlated with a high concentration of polyphenols. The present study demonstrated that Hemerocallis cultivars contain significant amounts of phenolic compounds with good skin-related activities and could be interesting as novel sources of bioactive agents for the pharmaceutical, food and cosmetic industries.

Phenolic Composition of the Leaves of Pyrola rotundifolia L. and Their Antioxidant and Cytotoxic Activity.

The leaves of Pyrola rotundifolia L. were extracted in the mixed solvent of methanol/acetone/water (2:2:1, v/v/v) and investigated for their phytochemical analysis and biological activity. Total phenolic and flavonoid contents were determined spectrophotometrically. A high content of phenols (208.35 mg GAE/g of dry extract), flavonoids (38.90 mg QE/g of dry extract) and gallotannins (722.91 GAE/g of dry extract) was obtained. Ultra-high performance liquid chromatography diode array detector tandem mass spectrometry (UHPLC-DAD-MS) allowed for the detection of 23 major peaks at 254 nm. The extract was analyzed for its antioxidant capacity using 2,2-diphenyl-1-picryl-hydrazyl (DPPH•) and 2,2'-azinobis[3-ethylbenzthiazoline]-6-sulfonic acid (ABTS•+) radical scavenging, metal chelating power and ß-carotene-linoleic acid bleaching assays. The examined extract showed moderate radical scavenging and chelating activity, and good inhibiting ability of linoleic acid oxidation (EC50 = 0.05 mg/mL) in comparison to standards. The cytotoxic effect in increasing concentration on five types of leukemic cell lines was also investigated using trypan blue vital staining. It was found that the analyzed extract induced the apoptosis of all the tested cell lines. Our findings suggest that the leaves of P. rotundifolia are a source of valuable compounds providing protection against oxidative damage, hence their use in traditional medicine is justified.

'Smoging kills' - Effects of air pollution on human respiratory system.

Atmospheric pollution suspended in humid air is popularly known as 'smog'. It is composed of dust particles of different sizes, as well as non-metal oxides, organic compounds, and heavy metals. Exposure to harmful substances suspended in the air - apart from, for example - smoking cigarettes, one of the modifiable factors leading to the development of respiratory diseases. There are six types of substances present in the air that have a negative impact on public health and result in significant consequences: ozone, particulate matter (PM) of different diameters - PM2.5µ, PM2.5‒10 µ, PM10 µ, nitrogen dioxide, sulphur dioxide, carbon monoxide and lead. Particular attention is given to small dust particles (PM10 and PM2.5) because they can penetrate into the lower respiratory tract. Apart from describing the composition of smog and sources of air pollution, the article also discusses the impact of atmospheric pollutants on both development and aggravation of the symptoms of such respiratory tract diseases as asthma, chronic obstructive pulmonary disease, respiratory infections and lung cancer. Some of legal measures applied in different countries aimed at reducing exposure to noxious air pollutants are reviewed. The authors believe that the increased focus on risks arising from inhaling toxic air pollution may be a first step for developing systemic solutions aimed at resolving or, at least, decreasing those risks.

Not only cigarettes - other culprits of lung cancer.

Introduction. Before cigarettes became popular, lung cancer was an extremely rare disease, but currently it is the most common cause worldwide of cancer death in both genders. Therefore, it constitutes a huge epidemiological, diagnostic and socio-economic challenge around the world. In Poland, lung cancer is the second most common carcinoma in both men and women, and it is also the most prevailing cause of carcinous death. Undoubtedly, although smoking classical cigarettes is the strongest risk factor of developing the cancer, unfortunately it is not the only one. Objective. The aim of this study was to present smoking-related factors, e.g. cigars, pipes, e-cigarettes or marijuana smoking, etiologically related to lung cancer incidence.

Thiram - Toxic inhalational lung injury.

INTRODUCTION: Thiram, a fungicides, is widely used on seeds and as foliar agent on turf, vegetables and fruit. It is also used in the rubber industry as a vulcanization accelerator. When absorbed through the respiratory system, it is rapidly metabolised to dimethylthiocarbamate and carbon disulphide, causing noxious effects. A brief review is presented of the literature, centering on the interesting case of a 45-year-old woman admitted to the hospital suffering from acute respiratory failure. RESULTS: Computer tomography in angiographic option (angio-CT) showed an extensive, irregular area of ground glass in both upper lobes and apical segments of the lower lobes of the lungs. A significant enlargement of both atria was also described. There was no improvement after cardiac treatment and patient was transferred to the pulmonary department where she was succesfully treated with systemic glucocortycosteroids. The patient remains under the supervision of the pulmonary out-patient department.