Personality Traits, Strategies of Coping with Stress and Psychophysical Wellbeing of Surgical and Non-Surgical Doctors in Poland.

The aim of the study was to determine the personality traits, strategies of coping with stress and psychophysical wellbeing of surgical and non-surgical Polish doctors. The study used the following questionnaires and scales: the Resiliency Assessment Scale, the Type D Personality Scale, the Framingham Type A Scale, the Mini COPE-Coping Inventory and the Wellbeing Scale. Doctors performing surgical specialties were characterized by a significantly higher level of resilience components, a more frequent occurrence of the type B behaviour pattern and less frequent type D personality than doctors performing non-surgical specializations. The Mini COPE point values were comparable between surgical and non-surgical physicians. The sense of psychological wellbeing was higher in surgical specialists. The higher the values of the Optimistic approach to life and the ability to mobilize oneself in difficult situations, the lower the values of the Turning to religion domain and the higher the values of the Denial domain correlated with the performance of surgical specialization. Men performing surgical specializations were more often optimistic and inclined to consume alcohol, while women with non-surgical specialization more often coped with stress by turning to religion. We conclude that the personality traits of Polish doctors vary depending on their specialization. Physicians' coping strategies do not differ depending on their specialization. The sense of mental wellbeing is higher in surgical specialists compared to non-surgical specialists. An optimistic approach to life and the ability to mobilize oneself in difficult situations, as well as coping with stress by denial are associated with the surgical specialization. Men performing surgical specialties more often declare optimism and a tendency to cope with stress by consuming alcohol or psychoactive substances, while women who perform non-surgical specializations more often cope with stress by turning to religion. Psychological screening tests and appropriate training, taking into account medical specialization, could be one way of improving resilience and coping with stress among doctors.

The effect of an oral sodium phosphate load on parathyroid hormone and fibroblast growth factor 23 secretion in normo- and hypercalciuric stone-forming patients.

BACKGROUND & AIMS: Abnormalities of parathyroid hormone (PTH) and fibroblast growth factor 23 (FGF23) secretion may cause calcium-phosphate (Ca-P) metabolism disorders in nephrolithiasis. Post-phosphate-load alterations in serum Ca, P and PTH, phosphaturia and calciuria enable monitoring hormonal regulation of Ca-P homeostasis. Our study aimed to determine differences in: 1.selected Ca-P metabolism parameters between healthy and kidney-stone-forming individuals, 2.PTH and FGF23 secretion induced by sodium-phosphate-load(NaP-load) in patients with/without hypercalciuria, 3.secretion of Ca-P related hormones in patients with low and normal/high serum concentrations of 25-hydroxyvitamin D3 (25OHD3). METHODS: Sodium phosphates NaH2PO4/Na2HPO4-100mmol were administered orally for five days in 19 hypercalciuric [urinary Ca(U-Ca) 6.5 ± 1.7 mmol/d]-HSF, 35 normocalciuric (2.5±1 mmol/d)-NSF stone-forming patients and 19 controls (U-Ca 2.5 ± 1.4 mmol/d)-CG. On days 1 and 5 PTH-,FGF23-,Ca-,P were determined before and after NaP-load. The areas under PTH, FGF23 curves (AUC) were calculated. U-Ca, urinary phosphate (U-P) and sodium (U-Na) were also determined. RESULTS: Following NaP-load, patients and controls exhibited expected alterations in Ca-P homeostasis. Despite changes in phosphate and PTH, no differences in FGF23 concentrations were observed. Patients differed from controls in having higher AUCPTH, calciuria and natriuresis, taking longer for PTH and P to normalize and lack of correlation between AUCPTH and phosphaturia. Post-NaP-load hypocalciuric effect of PTH secretion in NSF was less pronounced than in CG. In the HSFs, the hypocalciuric effect was more pronounced than in NSFs, but insufficient to correct hypercalciuria. In all stone-formers with low 25OHD3 concentrations, the AUCFGF23 was significantly increased on first (1215 ± 605vs766 ± 315 p = 0.0457) and fifth days (1211 ± 641vs777 ± 299 p = 0.041) of NaP-load, compared to normal/high 25OHD3-patients. Hypercalciuric patients with low 25OHD3 concentrations had greater AUCPTH5 than those with normal/high 25OHD3 (1005 ± 401vs835 ± 220 p = 0.0341). CONCLUSIONS: Compared to controls, kidney-stone-forming patients exhibited enhanced PTH secretion after NaP-load. The HSFs showed a more pronounced hypocalciuric effect than NSFs, but insufficient to correct hypercalciuria. In hypercalciuric stone-formers with low 25OHD3, FGF23 engagement in hyperphosphatemia reduction increased.

Childhood growth hormone treatment in women with Turner syndrome - benefits and adverse effects.

Turner syndrome (TS) is characterized by the partial or complete loss of one sex chromosome and results in growth failure, gonadal insufficiency and cardiac anomalies. Treatment with growth hormone (GH) during childhood has indisputable benefits when taking into account the low stature of TS women. Medical records and biochemical findings of 33 TS women treated with GH in childhood (GH+) were compared to those of 124 TS women who did not receive GH (GH-). It seems that the GH-treated group might have had a more severe initial phenotype than the untreated group, as evidenced by higher FSH, more feeding issues in infancy, more lymphedema cases and urinary system malformations. GH+ women were significantly taller and had a better lipid profile and lower prevalence of arterial hypertension than GH- . However, they also had lower thrombocyte counts, a greater prevalence of retrognathism and nail anomalies, especially when the GH treatment was delayed. Long-term GH use was not as effective for growth as GH treatment during the initial period and seemed to have resulted in elevated creatinine levels. GH treatment in childhood has benefits in adulthood; however, adverse effects may occur, especially in individuals with treatment that is delayed or is too long.

Nutritional Status Assessment in Children and Adolescents with Various Levels of Physical Activity in Aspect of Obesity.

INTRODUCTION: A rational way of nourishment, combined with adequate physical activity, are the basic components of maintaining proper body condition. OBJECTIVE: The aim of the study was to evaluate nutritional status among children and adolescents with different levels of physical activity. METHODS: The study group consisted of 1,013 students of both genders aged between 7 and 18 years attending elementary and post-primary schools (general and sports profile) in Siemianowice Slaskie. RESULTS: The crude body mass index (BMI) values ranged from 12.78 to 35.3. Body mass within the limits of arbitrary standard referred to 70% of the examined group, overweight or obesity was found in over 25%. Percentage of body fat (FATP) values ranged from 5.7 to 45.2%. CONCLUSIONS: A significant number of children and adolescents were overweight or obese based on BMI categories and FATP values. Overweight and obesity were most common among younger children, particularly boys. Higher torso FATP levels were more common among sports-oriented class students. BMI is not a good tool for the determination of the nutritional status of children and adolescents, while the bioelectric impedance method enables one to conduct a precise analysis of adipose tissue content and location. Sports-oriented elementary school students from the study group were characterized by higher FATP values.

New insights into clinical features, karyotypes, and age at diagnosis in women with Turner syndrome.

INTRODUCTION: Turner syndrome (TS) is due to a chromosomal abnormality in which only one normal X chromosome is present. The purpose of the study was the assessment the prevalence of phenotypic differences in TS-women and monosomy-45,X and with other karyotypes as well as the possible relationship between the presence of differentiating features and age at final TS diagnosis. MATERIAL AND METHODS: The prevalence of anomalies and abnormalities from history taking/physical examination of 157 TS-patients was compared to 25 healthy controls (age 27.3 ± 4.5 years). The age at TS-symptom occurrence and final TS diagnosis was also analysed. RESULTS: Ninety-three TS women with 45,X (25.2 ± 7.1y) and 64 with other karyotypes (non-45,X) (age 24.1 ± 8.2 years) had lower growth than controls (144 ± 7.6 and 145.7 ± 6.8 vs. 165.8 ± 6.6 cm, respectively; p < 0.001). Only 15 and 12 out of 37 non-gynaecological features occurred more frequently in 45,X and non-45,X, compared to controls. 45,X and non-45,X wpmen did not differ in terms of body height. Out of 60 study parameters, only nine differed significantly between 45,X TS women and those with other karyotypes. Mean age at TS-symptom occurrence (45,X: 6.8 ± 5.4 years; non-45,X: 10.3 ± 5.2 years; p < 0.001) and final TS diagnosis (45,X: 13.2 ± 8 years; non 45,X: 17 ± 8.2 years; p = 0.004) differed between TS groups. CONCLUSIONS: 1. The prevalence of the majority of clinical manifestations of Turner syndrome does not differ between TS women with 45,X monosomy and non-45,X karyotypes. 2. Certain manifestations of Turner syndrome are more prevalent in women with non-45,X karyotypes compared to those with 45,X monosomy. 3. Clinical manifestations, the prevalence of which differs between TS-women with non-45,X karyotypes and 45,X monosomy, might help lower the age at diagnosis.

Diabetes decreases patency of tunneled catheters in hemodialysis patients after first effective thrombolysis with urokinase.

INTRODUCTION: Fibrinolysis is one of the methods extending the use of vascular access in patients with tunneled venous catheters thrombosis. The aim of this study was to assess one-year maintenance of tunneled catheters patency after first effective thrombolysis with urokinase and identify its predictors. METHODS: Retrospective analysis included 85 patients (age 69 ± 13 years) with permanent venous catheter thrombosis treated with urokinase at one center in the period 2010-2016. Urokinase was used (depending on weight) at a dose of 10,000 or 20,000 IU in an 8 h infusion to each catheter line. Assessment of one-year efficacy of fibrinolysis included the time between fibrinolysis and following thrombosis of the same catheter in patients that have previously obtained at least partial blood flow. The analysis included medication, comorbidities, catheter patency time and INR value during first thrombosis episode. RESULTS: There were 62.4% patients with type-2 diabetes and 11.8% with neoplasm. The thrombolysis procedure was effective in 73 patients (85.9%). An analysis of the one-year efficacy of thrombolysis procedure included 73 patients. Among them, 23 experienced next episode of catheter-related thrombosis within a year postprocedure. Diabetes increased the risk for recurrent thrombosis [HR =3.19 (1.09-9.41); p = .03]. CONCLUSIONS: Patients with diabetes are at higher risk of recurrent catheter-related thrombosis and therefore may require more aggressive anticoagulation therapy for its prevention.

Social and medical determinants of quality of life and life satisfaction in women with Turner syndrome.

BACKGROUND: Turner syndrome (TS) appears in women as a result of the lack of part or the whole of one of the X chromosomes. It is characterized by the occurrence of low height, hypogonadism, numerous developmental defects, and is often accompanied by psychological disturbances. OBJECTIVES: Although the phenotype characteristics of women with TS are quite well documented, the knowledge of the impact of Turner syndrome on the satisfaction with life is still insufficient. The aim of our study was to assess the impact of TS on selected variables of quality of life, and hence also life satisfaction in women with this syndrome. MATERIAL AND METHODS: The research was carried out in a group of 176 women with TS starting March 1995. The patients underwent anthropological and medical examinations, and their medical histories were taken using a questionnaire that included demographic and psychosocial items as well as issues related to selected variables of quality of life. In our research model, general life satisfaction was a dependent variable. The statistical analysis was conducted using the eta and Cramer's V correlation coefficients as well as a multidimensional logistic regression model. RESULTS: The main determinants of dissatisfaction with life in women with TS were short stature and feelings of loneliness and being handicapped. CONCLUSIONS: The determinants of life satisfaction in women with Turner syndrome were closely related to the private life of the study participants, in particular self-perception and feelings concerning their health status.

Influence of etanercept on leptin and ghrelin secretion in children with juvenile idiopathic arthritis.

Objective To assess possible changes in leptin and ghrelin secretion due to etanercept in juvenile idiopathic arthritis (JIA). Methods 50 patients with JIA and 16 age-matched controls were enrolled into this prospective, cross-sectional study. Serum leptin, total and acyl ghrelin were measured in addition to white blood cell (WBC) and lymphocyte counts. Results 25 patients received etanercept and 25 conventional therapies (including methotrexate) for JIA. There was no difference between treatment and control groups in leptin or ghrelin levels and no evidence of a relationship between leptin and ghrelin in patients with JIA. In all children with JIA there was a correlation between leptin and body mass index (BMI). However, compared with children in the conventional treatment group, children in the etanercept group showed a positive correlation between total ghrelin and BMI and those with a low BMI showed a negative correlation between acyl ghrelin and BMI. Conclusion No differences in leptin and ghrelin concentrations were found when patients with JIA and controls were compared or when patients who received etanercept were compared with those who received conventional treatment for JIA.

Selected clinical features of the head and neck in women with Turner syndrome and the 45,X/46,XY karyotype.

INTRODUCTION: A 45,X/46,XY karyotype in women with Turner syndrome (TS) is very rare. The presence of a Y chromosome in the karyotype causes phenotypic differences and increased risk for neoplastic disease, compared to TS-women with other karyotypes. Our study addresses an issue: non-genital phenotypic differences between TS-patients with a Y-chromosome of their karyotype and TS-women without it. MATERIAL AND METHODS: Results from patient history/physical examinations of the head and neck of eight TS-women and the 45,X/46,XY karyotype were compared with those observed in 164 TS-women and 30 controls. The heights of TS-groups: 142.5 ± 7.2 and 144.9 ± 7.2 cm were lower than controls (165.2 ± 6.6 cm). Participants were examined from 1995 to 2014. RESULTS: Among 28 study parameters, 15 were more frequently observed in TS women with the 45,X/46,XY karyotype compared to controls. Only abnormalities in the oral cavity and a history of childhood lymphoedema, differed significantly in the TS groups. CONCLUSIONS: With respect to the head and neck, the patient history and physical examination results of TS-women and the 45,X/46,XY karyotype and TS and other karyotypes revealed similar differences compared to controls. Compared to others TS patients, 45,X/46,XY individuals might more frequently have oral cavity soft tissue abnormalities and more rarely a history of childhood lymphoedema. (Endokrynol Pol 2017; 68 (1): 47-52).

Leptin concentration in children with juvenile idiopathic arthritis.

INTRODUCTION: Leptin regulates the organism's immune response. Juvenile idiopathic arthritis (JIA) is a chronic joint disease in children, leading to chronic changes in motor organs. MATERIAL AND METHODS: In children with JIA (n = 42) and healthy subjects (n = 28), leptin concentration (LEP), body mass index (BMI), haematocrit (HTC), haemoglobin (HB), morphotic elements (WBC,LYMPH), erythrocyte sedimentation rate (ESR), and ANA Hep-2 antibodies were analysed. JIA group was divided into: children with a longer (51-148 months) (IA) n = 22 and a shorter disease period (2-18 months) (IB) n = 20. RESULTS: Only 58.3% of the IA and 50% of the IB group had ANA Hep-2 confirmed. The ill children had higher and more diversified LYMPH and ESR levels compared to the healthy children. The highest LEP for the IA group was 37.5 ng/cm3, (Me 5.85), for IB - 40.10 ng/cm3, (Me 2.46) as compared to the IC - 3.74 ng/cm3 (Me 2.85), respectively. The average BMI value for the IA group was 16.61 kg/m2, for IC it was 18.91 kg/m2, and the median for IB was 15.89 kg/m2. Children with BMI values < 23 kg/m2 from the IA and IB group had a reduction in LEP as compared to control group (p = 0.04). The relationship between the illness and LEP diversification per BMI unit was found in both groups. Children with a shorter illness period had higher LEP differentiation per BMI unit compared to the healthy children. CONCLUSIONS: Children with juvenile idiopathic arthritis with BMI < 23 kg/m2 had lower leptin concentrations than healthy subjects. Ill children with a shorter-term disease had a higher diversification of leptin concentration per BMI unit as compared to healthy controls.

The cohort effect in studies related to differences in psychosocial functioning of women with Turner syndrome.

INTRODUCTION: The physical health deficits and psychological disorders of women with Turner syndrome (TS) are the deciding factors in their treatment, but also their own relation to their own and their family's experiences. This study aimed to find the differences in psychosocial functioning of TS women coming from two different generations. These differences show the cohort effect as change in personal functioning and quality of life. MATERIAL AND METHODS: In-depth interviews were conducted with 176 TS women and their parents to collect data. The first cohort was composed of patients up to the age of 29 (n = 139), and the second included patients aged 30 or above (n = 37). Fifty-two variables, important from the point of view of health and quality of life, were analysed in two age groups. The paths models were compared to analyse differences between the cohorts. RESULTS: Belonging to a particular age cohort significantly affected the variance of the biomedical variables tested, which seems to be related to the therapeutic procedure due to an earlier diagnosis and treatment for younger patients. We also found differences in the number and strength of the correlations between the factors of psychosexual development, personal and family resources, socio-economic life, and professional or educational activity. CONCLUSIONS: (1) The psychosocial functioning of TS women changes over time. This is a kind of illustration of the cohort effect. (2) Medical aspects of Turner syndrome may remain in connection with the psychosocial functioning of patients, and determine their quality of life. (3) Psychosociological resources are more complex and involved in younger women with Turner syndrome.

The influence of hormonal replacement and growth hormone treatment on the lipids in Turner syndrome.

AIM: Women with Turner syndrome (TS) have a risk of developing cardiovascular diseases. We assessed the lipid and carbohydrate metabolism in TS-women in the context of current hormone replacement therapy (HRT) and growth hormone (GH) treatment during childhood. METHODS: The information were collected from medical documentation and anamnesis of 165 TS-women (24.9 ± 7.7 yr) between 1995 and 2011. The patients underwent a pituitary-gonadal axis assessment together with measurements of total cholesterol (TC), high- (HDL) and low- (LDL) density lipoproteins, triglycerides (TG), and glucose levels. RESULTS: Only 58% of women were using HRT. No differences were found in the levels of the lipid components and glucose in women who were undergoing HRT compared to those without it. Compared to TS-women without (n = 113), prior GH treatment in 34 TS-women positively influenced the lipid parameters: TC 5.0 ± 1.1 versus 4.6 ± 0.9 mmol/l (p = 0.03), HDL 1.5 ± 0.5 versus 1.4 ± 0.4 mmol/l (p > 0.05), LDL 3.3 ± 0.9 versus 2.9 ± 0.7 mmol/l (p = 0.03), and TG 1.1 ± 0.6 versus 0.8 ± 0.3 g/l (p = 0.009), respectively. CONCLUSIONS: (1) HRT does not affect lipid metabolism in TS-women. (2) The use of GH in TS-children favorably influences their lipid profile in adulthood.

[The values of peripheral blood cell count parameters in women with Turner's syndrome]. / Wartosci parametrów morfologii krwi obwodowej u kobiet z zespolem Turnera.

UNLABELLED: Turner's syndrome is a chromosomal anomaly which occurs in approximately one in 2500 females. The syndrome is characterized by the presence of primary gonadal dysgenesia which is manifested by, among others, amenorrhoea. Taking this fact into consideration, the values of blood cell count in Turner's syndrome women could have been expected to be better than the corresponding values in the general population of women. The aim of the present research is to evaluate the basics haematology parameters in women with Turner's syndrome. MATERIAL AND METHODS: Basic parameters of blood cell count were marked in 176 women with Turner's syndrome. One hundred and three subjects were found to have X monosomy, whereas the rest of the females had other types of karyotype. The results obtained were compared to the corresponding parameters in the general population of Polish women. RESULTS: There were no statistically significant differences between subjects with Turner's syndrome and general female population as far as the white blood system and the red blood system parameters were concerned. Similarly, the thrombocyte count failed to be significantly different in women with Turner's syndrome and in healthy women. However, Turner's syndrome subjects with 45, X karyotype, compared to females with other karyotypes, showed a significantly higher number of thrombocytes: 267.5 +/- 70 vs 240.1 +/- 69 thousand/mm3. CONCLUSIONS. 1. Basic parameters of peripheral blood count in women with Turner's syndrome do not differ from the reference values in general female population. 2. Turner's syndrome subjects with X monosomy are characterized by a significantly higher number of thrombocytes than other women.

[Responsiveness of parathyroid hormone secretion to a phosphate load in hypertensive patients with non insulin dependent diabetes mellitus]. / Wydzelanie parathormonu stymulowane doustnym obciazeniem fostoranem sodowym u chorych na cukrcyce 2 z nadcisnieniem tetniczym.

INTRODUCTION: Abnormalities in calcium phosphate (Ca-P) metabolism and Ca-P related hormones are well documented in patients with essential hypertension (EH), but less in patients with non insulin dependent diabetes mellitus (NIDDM). The present study was designed to assess the responsiveness of parathormone (PTH) secretion to an oral phosphate (Pi) load (100 mmol) in patients with EH - NTS and hypertensive patients with NIDDM - CNT. MATERIAL AND METHODS: In 29 patients in NTS group (45.6 +/- 1.3 y), 32 in CNT group (48.4 +/- 0.9 y) and in 23 healthy subjects-GK (42.7 +/- 2.7 y) - 25-OH-D(3), intact PTH, ionized (Ca(2+)) and phosphate (P) were estimated in blood serum before and PTH in 4, 8, 12, 18 and 24 hours, Ca(2+) and P in 2, 4, 6, 8, 10, 12, 18 and 24 hours after an oral administration of Pi. Urinary excretion of calcium and phosphate were also estimated on day before and at the day of an oral Pi load. RESULTS: In NTS group lower basal 25-OH-D(3) serum levels (22.9 +/- 1.7 vs. 30.9 +/- 2 ng/ml; p = 0.02), while in CNT group higher PTH (22.7 +/- +/- 2.2 vs. 15.6 +/- 1.9 pg/ml; p < 0.05) levels were found. Both NTS and CNT patients showed an exaggerated response of PTH secretion to the Pi load (as expressed as the AUC) as compared with GK [757 +/- 51.7 vs. 790 +/- 53.8 vs. 600 +/- 39 (pg/ml)*24 h]. In addition patients in groups NTS and CNT showed a higher calciuria than GK (2.48 +/- 0.2 and 2.42 +/- 0,2 vs. 1.77 +/- 0.2 mmol/d.) and a delayed normalization of plasma P at the day of the Pi load. CONCLUSIONS: 1. Both NTS and CNT groups are characterized by an abnormal calcium and phosphate metabolism and exaggerated response of PTH secretion to an oral phosphate load as compared with GK controls. 2. Probably hypertension and not NIDDM seems to be the leading cause of calcium-phosphate abnormalities in hypertensive diabetic patients.

Hormonal replacement therapy in women with Turner's syndrome in Poland: Analysis of 176 cases.

AIM: Turner syndrome (TS) is one of the forms of gonadal malfunction. The study aims at the analysis of hypophysis-gonad axis (HGA) of women with TS who use and do not use hormonal replacement therapy (HRT). METHOD: One hundred and seventy-six Poles with TS were investigated in the years 1995-2004. The information about the application of HRT was given during the interview. The HGA was examined by the estimation of gonadotropin (FSH, LH) and 17beta-estradiol (E(2)) levels. RESULTS: HRT was administered to 89% of women with TS at some point of their life. However, at the time of writing this report only 54% of them have been taking this drug. The variety of hormonal preparations used by the patients was great. In women with TS using the HRT, in contradiction to women with TS who do not use it, lower concentrations of FSH (32.1 +/- 22.1 vs. 44.2 +/- 23.3 IU/l) and LH (20.8 +/- 17.5 vs. 26.6 +/- 18.1 IU/l) as well as higher level of E(2) (135.5 +/- 147.9 vs. 89.9 +/- 100.6 pmol/l) were observed. The negative correlation between E(2) and FSH levels was not observed in women with TS using HRT, despite the elevation of 17beta-estradiol levels and the reduction of gonadotropin concentration. CONCLUSIONS: (1) Large percentage of women with TS does not use HRT. (2) Women with TS, who receive HRT, use this method of treatment insufficiently.

[Height correlation analysis between women with Turner syndrome, their sisters and parents]. / Ocena zaleznosci wzrostu kobiet z zespolem Turnera i ich sióstr od wzrostu rodziców.

INTRODUCTION: The most frequent physical features associated with Turner syndrome is short stature. The main goal of the research was to estimate the height of women with Turner syndrome and to analyze the correlation between their height and their sisters and parents height. MATERIAL AND METHODS: The research was based on the 176 women with Turner syndrome (number of parents = 176; number of sisters = 122). The data was collected from 1995 to 2002 in Out-patient Clinic for Women with Turner's Syndrome in Bytom. RESULTS: Average height in the group of women non treated with growth hormone and anabolic drugs was 144.1 +/- 6.8 cm (n = 105), mothers average height: 162 +/- 5.3 cm, fathers average height: 172.4 +/- 6.1 cm, sisters: 164.9 +/- 5.2 cm (n = 79). The height of women with karyotype 45,X was slightly shorter: 143.1 +/- 6.9 cm, while the height of the family have remained unchanged. Contrary to all untreated women with Turner syndrome where the height was correlated with the mothers and fathers height (pearson's r = 0.32 and 0.34 respectively), sisters height was correlated mainly with fathers height (pearson's r = 0.47 and 0.34 respectively). In the group with karyotype 45,X patients' height was correlated mainly with mothers height (r = 0.55). In this group sisters height is correlated stronger with fathers' height (r = 0.45) than with mothers' height (r = 0.35). CONCLUSIONS: 1. The height of non treated women with Turner syndrome is correlated with both parents height while the height of sisters is correlated mainly with fathers. 2. The height of Turner syndrome women with karyotype 45,X is correlated with their mothers height.

[Selected problems of the diagnosis of Turner's syndrome]. / Wybrane aspekty rozpoznania zespolu Turnera.

UNLABELLED: Turner's syndrome (TS) can be diagnosed in one out of 2130 females. The aim of the current study was to collect data about circumstances associated with the diagnosis of the syndrome. The material consisted of 177 female patients from the whole Polish territory, that turned to the out-patient Clinic for Women with Turner's syndrome, Specialist Hospital No 2 Bytom. Patients underwent physical examination and all relevant clinical information were analysed. The mean age when the abnormal symptoms were found was 8.5 years. Only 50% of those, who first turned their attention to these symptoms, were the health care workers. The initial symptoms were quite variable. Classical symptoms, i.e. short stature and amenorrhea were present respectively in only 41% and 8% of patients. In 16% of patients the diagnosis was significantly delayed, because, due to a lack of symptoms TS was not suspected. The latest cases were diagnosed at the age of 14.6 +/- 8.2 years. When it came to analysing karyotypes, simple chromosome X monosomy was present in 56% of patients and in 24% of cases mosaic karyotypes were found. Studies were performed in 14 cities in Poland. CONCLUSIONS: 1. In most cases diagnosis of TS was markedly delayed. 2. More efforts are required in order to perform karyotype studies in younger patients then it is now. Also molecular studies should become more easily available, since they are a necessary supplement to cytogenetic studies.

[Selected problems of the nephrological and urological status of women with Turner's syndrome]. / Wybrane aspekty nefrologiczne i urologiczne u kobiet z zespolem Turnera.

UNLABELLED: Nephrological and urological problems among women with Turner's syndrome (TS) have not been frequently investigated so far. The aim of our study was to address those issues in adult women with TS in Poland. 176 women with TS, whose age was between 18 and 51 years, who presented to our center from the whole territory of Poland between March, 1995 and December, 2002 were examined. A particular attention was payed to nephrological and urological status of those patients. 61 women (34.7%) presented with inflammatory status in urinary tract. In 24.6% of them anatomical, congenital defects of the urinary tract were discovered. Both the presence of inflammation as well as a defect itself have no influence on incidence and degree of arterial hypertension, diabetes mellitus, antropometric parameters of those patients with TS and other, laboratory parameters assessed. CONCLUSIONS: 1. Women with TS suffer from urinary tract inflammations significantly more frequently then it happens in general female population. 2. Urinary tract diseases among women with TS, associated with leukocyturia are either not related to, or related not only to the characteristics of the type of a particular congenital defect of the urinary tract.

[Effect of orlistat therapy on carbohydrate, lipid, vitamin and hormone plasma levels in obese subjects]. / Wplyw leczenia orlistatem na gospodarkt weglowodanowa, lipidowa, witaminowa i hormonalna u osób otylych.

UNLABELLED: Orlistat is an inhibitor of lipase which splits triglycerides into free fatty acides and glycerol. This drug, by inhibiting hydrolysis of triglycerides, is the cause of significant loss of fat in the faeces. 13 obese and 15 nonobese subjects were examined. Obese subjects received orlistat (Xenical, F. Hoffmann La Roche Ltd, Switzerland) 3 x 120 mg/d. Treatment with orlistat for 16 weeks was followed by a significant fall of BMI and MAP, insulinemia, insulin/glucose ratio, leptinemia, serum total cholesterol, triglycerides, HDL-cholesterol and 25-OH-D concentration respectively. Orlistat did not influence significantly serum LDL-cholesterol concentration but unexpectedly increased plasma levels of folic acid, vitamin B12 and NPY. CONCLUSIONS: (1) Monitoring of plasma 25-OH-D levels in obese patients on orlistat therapy seems to be mandatory. (2) In spite of significant changes (in opposite direction) in leptinemia and serum NPY level observed in obese subjects treated with orlistat, presence of a functional relationship between these hormones could not be confirmed.

[Psychically ill patients from the view point of students from high schools, specialized in nursing education]. / Postrzeganie chorego psychicznie przez studentów szkól medycznych.

The hypothesis that students from medical high schools present an open position to psychical ill patients was verified. There was made investigations through 30 of students from first year of Care and Teaching Health Class from Medical University of Silesia in Katowice. Students declared help and big interest for such kind of patients. We might see a big tolerance and acceptance through the investigated students. Probably, this kind of attitude was affected by media (TV, radio, press). Our results showed the ideal picture of students from nursery high school. On the other hand we have to think about the real attitude to psychical ill patients. Our future investigations during the next year of education will verify our preliminary results.