Adipose tissue is a dynamic endocrine organ that is essential to regulation of metabolism in humans. A new approach to mental disorders led to research on involvement of adipokines in the etiology of mental disorders and mood states and their impact on the health status of psychiatric patients, as well as the effects of treatment for mental health disorders on plasma levels of adipokines. There is evidence that disturbances in adipokine secretion are important in the pathogenesis, clinical presentation and outcome of mental disorders. Admittedly leptin and adiponectin are involved in pathophysiology of depression. A lot of disturbances in secretion and plasma levels of adipokines are observed in eating disorders with a significant impact on the symptoms and course of a disease. It is still a question whether observed dysregulation of adipokines secretion are primary or secondary. Moreover findings in this area are somewhat inconsistent, owing to differences in patient age, sex, socioeconomic status, smoking habits, level of physical activity, eating pathology, general health or medication. This was the rationale for our detailed investigation into the role of the endocrine functions of adipose tissue in mental disorders. It seems that we are continually at the beginning of understanding of the relation between adipose tissue and mental disorders.
Food consumption impacts CBC results. To ensure the consistency, quality, and repeatability of CBC analysis, blood should be drawn from fasting patients.
Background. The levels of protein C (PC), free protein S (PS) and antithrombin (AT) are evaluated during thrombophilia screening to exclude their deficiencies. Objectives. The aim of this study was to investigate factors which determine the elevated levels of natural plasma anticoagulants in healthy individuals. Material and Methods. The PC activity and antigen, free PS antigen and AT activity together with hematological, biochemical, genetic and immunological laboratory tests were assessed in 130 healthy adults (63 males) aged 20-60 (median 41) years. Individuals with personal or family history of cardiovascular diseases and venous thromboembolism were ineligible. Results. The functionally active PC measured by chromogenic assay (values above 140%) was observed in 14 (11%) of subjects, while the PC antigen determined using the enzyme-linked immunosorbent assay (ELISA) was elevated in 5 (4%) of these patients. Free PS measured by immunoturbidimetry and ELISA was increased in 9 (7%) subjects (values above 139% in men and 114% for women) and in 6 (5%) patients (values above 130% in men and 111% for women), respectively. The AT activity above 118% was found in 5 (4%) subjects measured using chromogenic assay. None of the individuals had any deficiency of natural anticoagulants. Increased C-reactive protein (CRP) > 3.0 mg/L was associated with elevated PC activity (odd ratio [OR]: 11.14, 95% confidence interval [CI] 1.67-74.23). Increased free PS assessed by immunoturbidimetric assay and PC activity were associated with hypercholesterolemia (OR: 3.57, 95% CI: 1. respectively). Body mass index ≥ 25 kg/m 2 was independently associated with elevated PC activity (OR: 3.42, 95% CI: 1.01-11.52). No risk factors for elevated AT activity were identified. Conclusions. Apart from hypercholesterolemia and overweight, increased serum CRP is associated with elevated PC activity in healthy adults. We confirmed that there are differences in the proportions of subjects with elevated PC and PS depending on the assay used (Adv Clin Exp Med 2015, 24, 5, 791-800).
Background: One of the most frequently performed emergency surgical procedures in children is an appendectomy. The aim of this study was to determine the benefits of supplementing standard, general anaesthesia with the ultrasound-guided right TAP block. Methods: We analyzed the medical records of 90 children of both sexes, aged 4-16 years with a body mass of 16-78 kg who underwent general anaesthesia for open appendectomy. Sixty-two individuals were anaesthetized using the standard method, while 28 patients had an additional right-sided TAP block under ultrasound guidance. Subsequently these groups were divided into 2 subgroups: children under 8 years and those older. We evaluated the total consumption of opioids, intraoperative fentanyl requirement, the amount of non-opioid analgesic and antiemetic drugs used during the whole hospitalization, time to recovery of digestive track function and length of hospital stay. Results: TAP block performed under USG guidance reduced the overall consumption of opioids (0.36 vs. 0.42 mg kg -1 , P = 0.048), significantly shortened time of fasting after the surgery (17 vs. 29 hours, P = 0.003) as well as reduced the need for antiemetic drugs: ondansetron were used only in 21.4% of children in the group with TAP block vs. 38.7% of children with standard protocol. Additionally, we noted that the application of the TAP block shortened the length of hospitalization (3 vs. 4 days, P = 0.045). Conclusion:The application of the TAP block, as a supplementary treatment to standard general anaesthesia for open appendectomy in children is a valuable component of multimodal analgesia, which might improve the quality of life of the patient and shorten the length of hospitalization.
Background/Aims: The objective of the study was to evaluate the circulating concentrations of plasma free fatty acids (FFA), fatty acid binding proteins: FABP-1 and FABP-4 in preterm infants depending on different feeding protocol. Methods: A total of 43 premature infants (≤34 weeks) were enrolled in the study, and divided into 3 subgroups: nursed while staying in the department (53%), breast-fed only during the first 24 h (16%), and formulafed from the beginning (31%). The control group consisted of 12 healthy, full-term, breast-fed newborns. Blood samples were collected after delivery and 1 month later. We measured plasma concentrations of FFA, FABP-1, and FABP-4. Results: FFA plasma concentrations were significantly lower in preterm babies when compared to control group (p = 0.003) in the prenatal period. After 1 month, a significant decrease in FFA concentration was noted in all groups of preterm babies independently from feeding protocol. After a month, breast-fed preterm infants and controls had significantly lower FABP-1 levels than preterm formula-fed infants (all p < 0.05), while the highest concentrations of FABP-4 were noted in formula-fed preterm infants when compared to breast-fed preterm infants and the control group (all p < 0.05). Conclusions: Prematurity is connected with disturbances in plasma FFA concentrations. FABP-1, as well as FABP-4, plasma levels in preterm infants depend on feeding protocol.
Alcoholism among minors is a serious social problem. The aim of the current study was to analyze alcohol intoxication in children based on hospitalizations in the University Children's Hospital in Cracow between the years 2007 and 2015. During these 9 years, 381 patients were hospitalized due to excessive alcohol consumption. Most patients were junior high school or high school students. The highest blood alcohol concentrations in hospitalized patients were found in a 16-year-old boy (BAC .41%) and a 15-year-old girl (BAC .37%). Alcohol consumption and severe intoxication are linked to a wide variety of familial, social, and personal problems.
Personal blood glucose meters (BGM) are used for the determination of glucose mainly by diabetic patients, but glucose meters for self-monitoring are also frequently in use in hospital wards as point-of-care test (POCT) devices. 1 The use of BGM, similarly to other diagnostic in vitro devices, requires permanent quality control (QC). The objective of the study was to analyze the recommendations of the QC performance of the BGM manufacturers and the evaluation of the compatibility of clinical practice with the recommendations.The manuals of the 27 BGMs, available on the Polish market (Arkray, Bayer, BSI, Bionime, Beurer medical, CSL, Diagnosis, Genexo, I-sense, Johnson & Johnson, MedTrust, Pharmbos, PTS, Roche), were studied in the terms of the QC. The heads of 29 hospital medical laboratories in the Malopolska province (Poland) were obliged to analyze the performance of the QC of BGM used in the hospital's wards and respond to the detailed questions presented in the questionnaire.Most of the manufacturers of analyzed BGM recommend to perform the QC upon the first use of the device, and in the case of suspected malfunction of the device or when the test strips do not function properly. Twenty-three (85%) BGM manufacturers recommend performing the QC if the test result is not consistent with the clinical symptoms. A recommended once-aweek QC performance was found only in 5 devices user manuals (19%). Sixteen (59%) companies suggest performing the QC test when a new box/vial of test strips is opened.Twenty-eight completed questionnaires, representing 96% of the distributed questionnaires, were returned. The internal QC performed, according to the manufacturers' recommendations, was carried out in 10 (42%) hospitals. Only in 1 hospital (4%) was the QC performed daily. Eleven (46%) of surveyed hospitals do not carried out QC of POCT BGM at all (Figure 1).It seems obvious that to receive reliable results of laboratory tests, the proper QC is required. The current standards for QC of BG measurement in laboratory require to perform it on 2 or 3 levels of glucose concentrations, 2 or 3 times every day. In the case of the QC for BGM according to the manufacturers suggestions are low-maintenance, and it is acceptable to perform QC once a week or less. Unfortunately, these nonrestrictive recommendations are not often respected in hospital wards where BGM are used as POCT devices. In many hospitals there is a lack of policy regarding QC for BGM. The potential risk of severe health consequences, when BGM are not properly controlled in the hospital, cannot be ignored. 2,3 It is essential to ensure proper hospital policy regarding QC for BGM use in the POCT. Over the past 30 years, experience in clinical chemistry has shown that regular and properly performed control of BG has a beneficial effect on morbidity, mortality of patients, and costs of treatment. 4 Therefore both diabetes associations and manufactures should clearly define unified recommendations for QC for glucose meters in self-monitoring as well as in POCT.
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