Effects of lifestyle-related risk factors on life expectancy: A comprehensive model for use in early prevention of premature mortality from noncommunicable diseases

Morbidity and premature mortality from noncommunicable diseases can be largely prevented by adopting a healthy lifestyle at the earliest possible age. However, tools designed for the early identification of those at risk among young adults are lacking. We developed and validated a multivariable model for the prediction of life expectancy, allowing the early identification of apparently healthy adults at risk of lifestyle-related diseases. We used a cross-sectional approach to calculate life expectancy using data from 38,481 participants of the National Health and Nutrition Examination Survey (1999-2014), aged ≥20 years. A multivariable logistic model was used to quantify the impact of risk factors on mortality. The model included the following lifestyle-related mortality risk factors as predictors: smoking, diet, physical activity, and body mass index. The presence of the following chronic diseases was considered: diabetes, arrhythmia, coronary artery disease, myocardial infarction, stroke, and malignant neoplasms. The model showed a good predictive ability; the area under the receiver operating characteristic curve measure was 0.846 (95% uncertainty interval 0.838-0.859). Life expectancy was determined using the life table method and the period life tables for the US population as the baseline. The results of this model underscore the importance of lifestyle-related risk factors in life expectancy. The difference between life expectancy for 30-year-old individuals with lifestyle characteristics ranked in 90% and 10% of their gender and age groups was 23 years for males and 18 years for females, whereas in 75% and 25%, it was 14 years for males and 10 years for females. In addition to early risk identification, the model estimates the deferred effect of lifestyle and the impact of lifestyle changes on life expectancy. Thus, it can be used in early prevention to demonstrate the potential risks and benefits of complex lifestyle modifications for educational purposes or to motivate behavioral changes.

Temperature-dependent Fermi surface probed by Shubnikov-de Haas oscillations in topological semimetal candidates DyBi and HoBi

Rare earth-based monopnictides are among the most intensively studied groups of materials in which extremely large magnetoresistance has been observed. This study explores magnetotransport properties of two representatives of this group, DyBi and HoBi. The extreme magnetoresistance is discovered in DyBi and confirmed in HoBi. At [Formula: see text] K and in [Formula: see text] T for both compounds, magnetoresistance reaches the order of magnitude of [Formula: see text]. For both materials, standard Kohler's rule is obeyed only in the temperature range from 50 to 300 K. At lower temperatures, extended Kohler's rule has to be invoked because carrier concentrations and mobilities strongly change with temperature and magnetic field. This is further proven by the observation of a quite rare temperature-dependence of oscillation frequencies in Shubnikov-de Haas effect. Rate of this dependence clearly changes at Néel temperature, reminiscent of a novel magnetic band splitting. Multi-frequency character of the observed Shubnikov-de Haas oscillations points to the coexistence of electron- and hole-type Fermi pockets in both studied materials. Overall, our results highlight correlation of temperature dependence of the Fermi surface with the magnetotransport properties of DyBi and HoBi.

Current Status Regarding Immunosuppressive Treatment in Patients after Renal Transplantation

Renal transplantation is now the best treatment for end-stage renal failure. To avoid rejection and prolong graft function, organ recipients need immunosuppressive therapy. The immunosuppressive drugs used depends on many factors, including time since transplantation (induction or maintenance), aetiology of the disease, and/or condition of the graft. Immunosuppressive treatment needs to be personalised, and hospitals and clinics have differing protocols and preparations depending on experience. Renal transplant recipient maintenance treatment is mostly based on triple-drug therapy containing calcineurin inhibitors, corticosteroids, and antiproliferative drugs. In addition to the desired effect, the use of immunosuppressive drugs carries risks of certain side effects. Therefore, new immunosuppressive drugs and immunosuppressive protocols are being sought that exert fewer side effects, which could maximise efficacy and reduce toxicity and, in this way, reduce both morbidity and mortality, as well as increase opportunities to modify individual immunosuppression for renal recipients of all ages. The aim of the current review is to describe the classes of immunosuppressive drugs and their mode of action, which are divided by induction and maintenance treatment. An additional aspect of the current review is a description of immune system activity modulation by the drugs used in renal transplant recipients. Complications associated with the use of immunosuppressive drugs and other immunosuppressive treatment options used in kidney transplant recipients have also been described.

Investigation of the Temperature Effect on Electrical Characteristics of Al/SiO2/n++-Si RRAM Devices

In this work, we investigate the effect of temperature on the electrical characteristics of Al/SiO₂/n++-Si RRAM devices. We study the electroforming process and show that forming voltage and time-to-breakdown are well described by Weibull distribution. Experimental current-voltage characteristics of Al-SiO₂-(n++Si) structures are presented and discussed at different temperatures. We show that some intermediate resistance states can be observed at higher temperatures. In our analysis, we identify Space Charge Limited Conduction (SCLC) as the dominating transport mechanism regardless of the operating temperature.

Analysis of Dietary Habits and Nutritional Status of Children with Down Syndrome in the Context of Lipid and Oxidative Stress Parameters

Introduction: The risk of obesity in children with Down syndrome is high. Undoubtedly, proper nutrition plays an important role in the prevention of excess body weight and is associated with a reduction of metabolic complications. The aim of the study was to assess the problem of disturbances in the nutritional status and eating habits of children with DS. Methods: A total of 39 patients were included in the study. The nutritional status was assessed by anthropometric tests and Dual X-ray Absorptiometry. Eating habits were assessed using the Child Eating Behavior Questionnaire and the Food Frequency Questionnaire. Blood samples were taken to determine the oxidative stress and lipid parameters. Results: Obesity was recognized in 15% of subjects and 23% were overweight. Children that were overweight were characterized by higher levels of triglycerides, atherogenic index of plasma, and apoA2 and apoE levels. Fat mass, fat mass/height² index, and visceral fat mass correlated with thiobarbituric acid reactive substances and advanced oxidative protein product level. The analysis of the Child Eating Behavior Questionnaire showed that children struggling with being overweight were more interested in food compared to those with normal body weight. A positive correlation was identified between waist circumference and food interest categories. Insufficient consumption of dairy products, vegetables, whole grain products, as well as fruits, seeds, nuts, and fatty fish was noted. Patients were less likely to consume products that are a good source of mono- and polyunsaturated fatty acids. Conclusions: In children with Down syndrome and obesity, disturbances in lipid and oxidative stress parameters are observed. Abnormal eating habits in all children with Down syndrome regardless of their nutritional status were noted. Proper nutritional education, nutritional control, and management of metabolic problems are essential in this group of patients.

Incidence of thyroid nodules in early stage autosomal polycystic kidney disease

Background

Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease. Defect in cilia-mediated signaling activity is a crucial factor leading to cyst formation. Hence, ADPKD is regarded as a systemic disorder with multiple extrarenal complications, including cysts in other organs, for instance, the liver, pancreas, spleen, or ovaries. Interestingly, loss-of-function of primary cilia has been recently found to contribute to a malignant transformation from degenerated thyroid follicles. However, the increased incidence of thyroid nodules in ADPKD patients has not yet been fully confirmed.

Objectives

To determine the incidence of thyroid lesions in patients with ADPKD in comparison to previous population studies. Moreover, we aimed to investigate if the pace of the disease progression is associated with a higher prevalence of thyroid lesions.

Material and methods

In 49 early-stage ADPKD patients recruited from our center, we performed ultrasonography of the thyroid glands, and laboratory evaluation of thyroids function. We compared the results with population studies.

Results

Twenty-three individuals had solid, cystic-solid, or cystic lesions revealed in the ultrasonography and 2 patients had a positive past medical history for thyroidectomy due to nodular goiter. In 10 patients out of the 23, only minor cysts with no clinical significance were found and 13 out of the 23 patients had solid or cystic-solid lesions, which occurred to be benign based on three years of follow-up or the biopsy of the nodule.

Conclusions

We found no increased incidence of thyroid gland lesions in early ADPKD patients in comparison to previous population studies. Plausibly, mechanisms other than defective cilia signaling are involved in the risk for focal thyroid lesions formation. Moreover, the rate of progression of kidney function decline seems to be not accompanied by the higher incidence of thyroid pathology.

Passive Photonic Integrated Circuits Elements Fabricated on a Silicon Nitride Platform

The fabrication processes for silicon nitride photonic integrated circuits evolved from microelectronics components technology—basic processes have common roots and can be executed using the same type of equipment. In comparison to that of electronics components, passive photonic structures require fewer manufacturing steps and fabricated elements have larger critical dimensions. In this work, we present and discuss our first results on design and development of fundamental building blocks for silicon nitride integrated photonic platform. The scope of the work covers the full design and manufacturing chain, from numerical simulations of optical elements, design, and fabrication of the test structures to optical characterization and analysis the results. In particular, technological processes were developed and evaluated for fabrication of the waveguides (WGs), multimode interferometers (MMIs), and arrayed waveguide gratings (AWGs), which confirmed the potential of the technology and correctness of the proposed approach.

The Current Role of Parathyroid Fine-Needle Biopsy (P-FNAB) with iPTH-Washout Concentration (iPTH-WC) in Primary Hyperparathyroidism: A Single Center Experience and Literature Review

Introduction. Primary hyperparathyroidism (PHPT) is a condition characterized by disorders of calcium–phosphate metabolism and bone metabolism caused by pathological overproduction of parathyroid hormone (PTH). The diagnosis of overt PHPT is based on the presence of clinical symptoms and laboratory abnormalities typical of this condition: hypercalcemia, hypercalciuria and elevated iPTH levels. Imaging studies are not used for diagnostic purposes; they are performed to localize the parathyroid glands prior to potential surgical treatment. Technetium 99 m sestamibi scintigraphy (Tc99 m-MIBI) is the gold standard in the assessment of pathologically altered parathyroid glands. Other diagnostic options include cervical ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET). Parathyroid biopsy (P-FNAB) with iPTH washout concentration (iPTH-WC) assessment is still an underestimated method of preoperative parathyroid gland localization. Few studies have reported the utility of US-guided P-FNAB in preoperative assessment of parathyroid lesions. The aim of the study was to present our experience with 143 P-FNAB with iPTH-WC assessment. Material and methods. Laboratory results, US findings, P-FNAB complications and comparison with other imaging techniques were described and analyzed. Results. In 133 (93.0) patients, iPTH washout-to-serum ratio exceeded threshold level 0.5 and were classified as positive results. Median iPTH-WC in this group was 16,856 pg/mL, and the iPTH-WC to serum iPTH ratio was 158. There was no correlation between iPTH-WC and serum PTH, serum calcium, parathyroid gland volume and shape index. In the group of 46 operated patients, 44 demonstrated positive iPTH-WC results, which corresponds to a sensitivity of 95.6%. In Tc99-MIBI, radiotracer retention was found in 17 cases (in 24 MIBI performed), which corresponds to a sensitivity of 52.2%. P-FNAB did not cause any major side effects −92.5% of all patients had no or mild adverse events after this procedure. Conclusions. P-FNAB with iPTH-WC is a reliable method in parathyroid adenoma localization during PHPT. Its sensitivity for diagnosis of PHPT is much higher than that of Tc99-MIBI, and in some situations, P-FNAB with iPTH-WC may even replace that method. Furthermore, cost-effectiveness of iPTH-WC is at least similar to that of Tc99-MIBI. Complications of P-FNAB are mild and we can describe this method as a safe procedure.

A thymoma or not a thymoma-that is the question: a case report

Thymomas are malignant, epithelial tumors of the thymus of diverse morphology that may metastasize or relapse after resection. The WHO histological classification includes five main subtypes A, AB, B1, B2 and B3. Types A and AB usually harbour a specific GTF2I gene mutation. Thymolipomas are very rare, benign tumors composed of thymic parenchyma and adipose tissue. We present the case of a 37-year-old male with an incidentally found mediastinal tumor that shared morphological features of a thymoma of unknown histological type and a thymolipoma-like tumor. Microscopically the tumor contained three components: (I) a highly organoid component that reproduced the thymic parenchyma with numerous Hassall corpuscles; (II) a lymphocyte-poor, epithelial component; (III) mature adipose tissue. A wide panel of immunohistochemical tests was used, but the results were not decisive for differential diagnosis. Genetic analysis of GTF2I, BRAF and NRAS genes revealed no mutations. The tumor was completely resected. The patient did not receive adjuvant radiotherapy. A 1.5 years after resection there was no evidence of tumor recurrence. Based on our case we carefully analyse and compare the microscopic features of thymoma vs. thymolipoma. The differentiation between these tumors is crucial due to their distinct clinical course and required therapeutic approach.

Investigation of Electrical Properties of the Al/SiO2/n++-Si Resistive Switching Structures by Means of Static, Admittance, and Impedance Spectroscopy Measurements

In this study, the resistive switching phenomenon in Al/SiO2/n⁺⁺-Si structures is observed and studied by means of DC, small-signal admittance, and complex impedance spectroscopy measurements. Possible transport mechanisms in the high and low resistance states are identified. Based on the results of the applied measurement techniques, an electrical equivalent circuit of the structure is proposed. We discuss the effect of parasitic elements influencing the measurement results and show that a proper model can give useful information about the electrical properties of the device. A good agreement between the characteristics of the proposed equivalent circuit and the experimental data, based on different measurement procedures, confirms the validity of the used methodology and its applicability to the electrical characterization of RRAMs.

Architectural Aspects of a Data-Intensive System: A Covid-19 Related Case Study

The Covid-19 pandemic caused serious turbulences in most aspects of humans activities. Due to the need to address the epidemic developments at extreme scales, ranging from the entire population of the country down to the level of individual citizens, a construction of adequate mathematical models faces substantial difficulties caused by lacking knowledge of the mechanisms driving transmission of the infections and the very nature of the resulting disease. Therefore, in modeling Covid-19 and its effects, a shift from the knowledge-intensive systems paradigm to the data-intensive one is needed. The current paper is devoted to the architecture of ProME, a data-intensive system for forecasting the Covid-19 and decision making support needed to mitigate the pandemics effects. The system has been constructed to address the mentioned challenges and to allow further relatively easy adaptations to the dynamically changing situation. The system is mainly based on open-source solutions so can be reproduced whenever similar challenges occur.

The utility of fluorescence in situ hybridization (FISH) in determining DNA damage-inducible transcript 3 (DDIT3) amplification in dedifferentiated liposarcomas - an important diagnostic pitfall

BACKGROUND AND OBJECTIVE

Dedifferentiated liposarcoma (DDLPS) is characterized by non-lipogenic sarcoma fields coexisting with adipocyte-rich well-differentiated areas. Amplification of the 12q13-15 region includes the MDM2 and DDIT3 genes. MDM2 amplification is considered a genetic hallmark of DDLPS, while DDIT3 is typically rearranged in myxoid liposarcoma. Recent studies showed that DDIT3 amplification is associated with myxoid liposarcoma-like (LPS-like) morphology in DDLPS. Our study aimed to evaluate the status of MDM2 and DDIT3 by FISH in DDLPS and correlate it with MLPS-like features.

MATERIAL AND METHODS

Six patients with MLPS-like morphology DDLPS were investigated pathologically, immunohistochemically, and genetically. The control groups of patients with classical DDLPS morphology and well-differentiated liposarcoma (WDLPS) were established and molecularly assessed as well. Fluorescence in situ hybridization (FISH) used in routine diagnostics was performed to determine the status of MDM2 and DDIT3 genes.

RESULTS

The patient's mean age was 64 (range from 43 to 85 years) with a 5:4 male to female ratio. Tumors were localized retroperitoneally (15) and extra-retroperitoneally (3). All cases demonstrated amplification of the 12q15 region containing MDM2 gene and co-amplification of the 5' DDIT3 FISH Probe representing DDIT3 telomeric tag. However, we did not find the relation of myxoid LPS-like morphology with DDIT3 amplification as previously reported.

CONCLUSIONS

The biopsy material from DDLPS with myxoid areas can be misclassified as myxoid liposarcoma. Indeed, according to the histological image, DDIT3 status may be evaluated first. In these cases, we show that the DDIT3 telomeric tag amplification assessed by FISH, is a common, nonspecific feature, which is also found in classical DDLPS and WDLPS. Therefore, we believe that co-amplification of DDIT3 and MDM2 may be considered a spectrum of the 12q13-15 region amplification due to the specification of FISH methodology.

Effects of trimetazidine in patients with severe chronic heart failure with reduced left ventricular ejection fraction: A prospective, randomized, open-label, cross-over study

BACKGROUND

Trimetazidine (TMZ) modulates cardiac metabolism, but its use in heart failure remains controversial. The aim of the study was to evaluate the effects of TMZ on exercise capacity, left ventricular ejection fraction (LVEF), mortality, and quality of life in stable patients with heart failure with reduced left ventricular ejection fraction (HFrEF).

METHODS

Forty-five patients with stable advanced HFrEF treated with optimal medical therapy were randomized in a prospective, single-center, open-label, cross-over study of trimetazidine (35 mg b.i.d.) on top of standard medical therapy or standard pharmacotherapy for two periods of 30 days and one period of 6 months. Initially and at the end of each period all patients underwent the following: exercise testing, six-minute walk test (6MWT), two-dimensional-echocardiography, and quality of life assessment.

RESULTS

The mean age of patients was 58.2 ± 10.6 years. Etiology of HFrEF was ischemic in 66.6% of patients. After 6 months no significant changes were observed in either group with regards to peak VO₂ uptake, 6MWT, LVEF, or quality of life. TMZ had no effect on mortality or cardiovascular events.

CONCLUSIONS

The additional use of TMZ on top of standard medical therapy in stable advanced HFrEF patients was not associated with significant changes in mortality, exercise capacity, LVEF, or quality of life.

Correlation analysis of cortisol concentration in hair versus concentrations in serum, saliva, and urine

INTRODUCTION

Cortisol concentration is measured in blood, urine, and saliva samples. It has been recently proven that cortisol could also be detected in hair samples. Cortisol measurements in different samples have their own individual characteristics and clinical utility. We aimed to investigate the correlation between hair cortisol concentration and standard cortisol measurements used in clinical practice.

MATERIAL AND METHODS

Fifty adult volunteers with a negative history of endocrine disorders were enrolled in the study. Morning serum cortisol (MSC), evening serum cortisol (ESC), evening free salivary cortisol (EFSC), urine free cortisol (UFC), and hair cortisol concentration (HCC) were analysed in all participants. Eventually, 41 volunteers were included into the study, whose cortisol concentration in the 1 mg overnight dexamethasone suppression test (1 mg ONDST) were < 50 nmol/L, and cortisol levels in serum, saliva, and urine were within reference ranges. Hair cortisol concentration test was performed for 20 mg of hair strands of the proximal 1 cm hair segments.

RESULTS

Hair cortisol concentration ranged from 0.3036 to 2.65 nmol/mg, and the average value was 0.8125 ± 0.4834 nmol/mg. No significant correlations were found between HCC and MSC (rho = 0.04419, p = 0.7838), HCC and ESC (rho = -0.2071, p = 0.1938), HCC and EFSC (rho = 0.1005, p = 0.532), or HCC and UFC (rho = 0.1793, p = 0.262).

CONCLUSIONS

This work is another step in the discussion on the application of HCC determinations in clinical practice. Our results have showed no correlations between HCC and single point cortisol assessment in blood, saliva, and urine in patients with reference cortisol levels.

Expression of adiponectin receptors 1 and 2 and the leptin receptor in human adrenal tumors

INTRODUCTION

The role of adipokines in neoplasms not related to obesity is unclear. The presence of adiponectin receptors 1 and 2 (AdipoR1 and AdipoR2) as well as the leptin receptor (Ob-R) has been recognized in human adrenal tumors. The authors of the present study were the first to compare the expression of these receptors in histopathologically distinct adrenal tumors.

MATERIAL AND METHODS

The study encompassed tissue specimens of 128 patients with adrenal tumors (28 adrenal cortical adenomas (CA), 35 cortical nodular hyperplasia tumors (CNH), 20 cortical carcinomas (CC), 40 pheochromocytomas (PHEO), 5 malignant pheochromocytomas (PHEOM)) operated on at a single clinical center. The expression of the adiponectin receptors AdipoR1 and AdipoR2 as well as the leptin receptor Ob-R was assessed by immunohistochemistry. The results were correlated with body mass index (BMI) and gender of the patients.

RESULTS

AdipoR1 expression was significantly higher in cortical cancers (p < 0.001) and pheochromocytomas (p < 0.001) as compared to benign cortical tumors. AdipoR2 expression was significantly higher in cortical carcinomas as compared to cortical adenomas and hyperplasia tumors (p = 0.01), and also significantly higher in pheochromocytomas in comparison to adrenocortical cancers (p = 0.004). Leptin receptor expression was absent or minimal in half of nodular hyperplasia tumors and adrenal cortex adenomas. This receptor's expression was significantly higher in adrenocortical cancers (p = 0.038). In pheochromocytomas this receptor was expressed more abundantly than in adrenocortical cancers (p = 0.004).

CONCLUSIONS

These novel findings suggest that adiponectin and leptin receptors could play a regulatory role in human adrenal neoplasms.

Hair cortisol concentration in a population without hypothalamic-pituitary-adrenal axis disorders

BACKGROUND

Measuring hair cortisol seems to be a good alternative to laboratory tests used thus far in routine endocrine diagnostics, primarily because it is independent of the circadian rhythm of cortisol. Due to the average hair growth of 1 cm per month, the results are related to the average blood cortisol levels over the previous weeks, months or years (depending on the length of the hair sample).

OBJECTIVES

The aim of this study is an attempt to apply hair cortisol concentration (HCC) measurements to clinical endocrine diagnostics, based on reference cortisol concentrations in the blood in a population without disorders of the hypothalamic-pituitary-adrenal axis (HPA).

MATERIAL AND METHODS

In the final selection process, 44 patients were enrolled in the study, all with negative interviews regarding disorders of the HPA and with reference levels of cortisol concentration obtained in routine laboratory tests. In the pre-analytic phase, we used 1 cm proximal hair strands cut from the posterior vertex area of the head, followed by the incubation of a 20 mg hair sample in methanol. The final cortisol measurement was done using an enzyme-linked immunosorbent assay (ELISA).

RESULTS

The results of HCC ranged from 2 pg/mg up to 51.63 pg/mg. The diurnal decrease in cortisol levels was significantly lower in females than in males (p = 0.031), but we do not consider that difference to be clinically significant. The difference in the HCC between males and females was not statistically significant (p = 0.767). The linear regression coefficient for age was not statistically significant (p = 0.847). Neither the regression coefficients for gender nor the gender and age interactions were statistically significant (p = 0.815).

CONCLUSIONS

Hair cortisol concentration measurement, unlike other endocrinological tests, gives information about the cortisol concentration in the long-term perspective. The results obtained in this study may be used as a reference for further research aimed at determining normal values of HCC.

Expression of adiponectin and leptin receptors in adrenal incidentaloma patients with subclinical hormone secretion

BACKGROUND

The role of adopokines in adrenal tumors' hormonal activity remains unclear. Obesity may induce arterial hypertension, disorders of carbohydrate metabolism, and is a risk factor of cardiovascular disease. In patients with subclinical hormone secretion by the adrenal cortex or medulla the risk of metabolic disease is increased.

OBJECTIVE

Authors of this retrospective study selected 78 patients with subclinical hormone secretion out of all adrenal incidentaloma patients hospitalized in the Department of Endocrinology and Internal Medicine between 1995 and 2014.

METHODS

The analyzed group comprised of 38 subclinical Cushing's syndrome (SCS), 40 incidentally discovered pheochromocytoma (PHEO) and 42 patients operated due to an adrenal tumor without pathological hormonal activity. Expression of adiponectin (AdipoR1, AdipoR2) and leptin (Ob-R) receptors in adrenal tumors was assessed in relation to body mass index (BMI) and hormonal activity.

RESULTS

We found statistically significant negative correlations between BMI and expression of all examined receptors in SCS patients (AdipoR1: p= 0.032; AdipoR2: p< 0.001; leptin Ob-R: p= 0.001). In PHEOs, BMI correlated negatively only with AdipoR2 (p= 0.014).

CONCLUSIONS

Data obtained show that the most significant factor associated with the expression of AdipoR1, AdipoR2 and leptin Ob-R receptors in the adrenal tumor tissue is BMI, not their hormonal activity.

New field-induced single ion magnets based on prolate Er(iii) and Yb(iii) ions: tuning the energy barrierUeffby the choice of counterions within an N3-tridentate Schiff-base scaffold

Counterions modulate the structure and magnetic properties of rarely observed high-coordinate SIM species.

Epidemiology, risk factors and prognosis of Interferon alpha induced thyroid disorders. A Prospective Clinical Study

INTRODUCTION

Hepatitis C virus (HCV) infection is a worldwide problem and hepatitis, which is its natural unfavourable course, is still a challenge for hepatologist. At present, standards of treatment are changing from combined therapy with interferon alpha (IFN-α) and ribavirin to new antiviral drugs. The current classification divides interferon induced thyroid diseases (IITD) into two groups: autoimmune (Hashimoto disease, Graves disease, positive antithyroid autoantibodies in euthyroid patients) and non-autoimmune (destructive thyroiditis, non-autoimmune hypothyroidism). A common complication of cytokine therapy is the induction of antithyroid autoantibodies de novo without thyroid dysfunction. During therapeutic regimens combined with ribavirin, destructive thyroiditis with typical biphasic course is more common than in IFN-α monotherapy. Clinically, overt pathologies often have discrete symptoms, which cause diagnostic and therapeutic dilemmas.

AIMS

The aim of this study was to estimate IITD occurrence, to find risk factors for IITD development.

MATERIAL AND METHODS

The study group consisted of 66 patients treated for HCV infection. Before and during antiviral therapy, hormonal (TSH, fT4, fT3), immunological (thyroid autoantibodies), ultrasonographic and genetic (HLA-A2) parameters were evaluated.

RESULTS

Hormonal disturbances were detected in 24.2% of patients; however, 43.9% of patients had positive thyroid autoantibodies (de novo) without hormonal imbalance. Multivariate analysis revealed the following: female sex, elevated TSH level, occurrence of anti-TPO autoantibodies (TPO-Ab), and increased blood velocity in thyroid arteries are risk factors for IITD development.

IN CONCLUSION

Thyroid disorders are common during IFN-α therapy. Previous epidemiological data seem to be underestimated. Important risk factors for IITD development are: female sex, elevated serum TSH concentration (≥2.5 μU/mL), positive TPO-Ab and increased blood velocity in thyroid arteries.

Diagnostic and prognostic role of SF1, IGF2, Ki67, p53, adiponectin, and leptin receptors in human adrenal cortical tumors

BACKGROUND

The authors have examined the immunohistochemical expression of several proteins and their relationship with adrenal cortical carcinoma (ACC) diagnosis and progression.

MATERIALS AND METHODS

A total of 83 patients with benign and malignant adrenal cortex tumors operated on in a single center were included in the study. Expression of the following proteins was examined: steroidogenic factor 1 (SF1), insulin growth factor 2 (IGF2), Ki67, p53, as well as adiponectin (Adipo R1, Adipo R2), and leptin (Ob-R) receptors.

RESULTS

Multivariate analysis revealed that the expression of SF1, IGF2, and Adipo R1 and R2 receptors was associated with ACC diagnosis. An acknowledged proliferation marker Ki67 was related with the size of ACC and was an independent ACC diagnosis marker. The authors also assessed the relationship between immunohistochemical parameters and overall survival (OS) and disease progression. Only high IGF2 expression was associated with longer OS (P = 0.025). The most significant one for the prognosis of ACC patients was tumor resectability of the primary tumor. More favorable prognosis was found for young men (P = 0.033).

CONCLUSIONS

The presented data indicate that immunohistochemical assessment (of IGF2, SF1, Adipo R1, and R2 receptors' expression) may be useful in making the diagnosis of uncertain ACC cases.

Search for unconventional superconductors among the YTE 2Si2 compounds (TE = Cr, Co, Ni, Rh, Pd, Pt)

Motivated by the recent discovery of exotic superconductivity in YFe₂Ge₂ we undertook reinvestigation of formation and physical properties of yttrium-based 1:2:2 silicides. Here we report on syntheses and crystal structures of the YTE ₂Si₂ compounds with TE  =  Cr, Co, Ni, Rh, Pd and Pt, and their low-temperature physical properties measurements, supplemented by results of fully relativistic full-potential local-orbital minimum basis band structure calculations. We confirm that most of the members of that family crystallize in a tetragonal ThCr₂Si₂-type structure (space group I4/mmm) and have three-dimensional Fermi surface, while only one of them (YPt₂Si₂) forms with a closely-related primitive CaBe₂Ge₂-type unit cell (space group P4/nmm) and possess quasi-two-dimensional Fermi surface sheets. Physical measurements indicated that BCS-like superconductivity is observed only in YPt₂Si₂ (T _c  =  1.54 K) and YPd₂Si₂ (T _c  =  0.43 K), while no superconducting phase transition was found in other systems at least down to 0.35 K. Thermal analysis showed no polymorphism in both superconducting phases. No clear relation between the superconductivity and the crystal structure (and dimensionality of the Fermi surface) was observed.

Probability and pattern of occult cervical lymph node metastases in primary parotid carcinoma

The present study was undertaken to evaluate real probability and pattern of cervical occult lymph node metastases (OLNM) in primary parotid carcinoma (PPC). We carried out a retrospective analysis of 66 patients treated in years 1992-2010 due to PPC, who underwent elective neck dissection (END). In search of risk factors for OLNM, we analysed the following parameters: age, sex, pT-Status, tumour size, skin invasion, facial nerve palsy, tumour fixation, extraparotid extension, localization, grade, histology, intra/periparotid LN metastases (IPLNM). OLNM was observed in 30.3% of patients. In a univariate analysis statistical significance was found for IPLNM, extraparotid extension and high risk histology. A multivariate analysis showed statistical significance only for the first variable. The most common location of cervical OLNM was level II (80%), then III (45%) and V (30%). In a compilation of our own material with data from the literature (5 series), we obtained a group of 80 patients with OLNM, selected out of 650 patients with cN0 (12.3%). The proportion of metastases to particular levels was the following: 69%-II, 22.5%-III, 20%-I,16%-V, 7.5%-IV. END should be carried out in case of all T3/T4a carcinomas with minimal range of levels II and III. Removal of levels Ib and Va is recommended as well. In the T1/T2 carcinomas with high grade/high risk histology, END should be performed including levels II and III.

Fasting and post-prandial peptide YY levels in obese patients before and after mini versus Roux-en-Y gastric bypass

BACKGROUNDː The mechanisms underlying the metabolic effect of surgical treatment for morbid obesity are still unclear. Furthermore, the hormonal and metabolic response to the promising and less-invasive version of Roux-en-Y gastric bypass (RYGB), i.e. mini gastric bypass (MGB), is poorly known. The aim of this study was to evaluate pre- and postprandial changes in peptide YY (PYY) and metabolic parameters in obese patients without diabetes and cardiovascular complications treated by both versions of gastric bypass. METHODSː Venous blood for PYY and other assays was collected three months before and six months after bariatric operation (MGB and RYGB), in the fasting state and two hours after the consumption of a standard 300-kcal mixed meal (Nutridrink Standard, Nutricia Advanced Medical Nutrition, part of the Danone company, Schiphol, The Netherlands). RESULTSː In the MGB group, elevated concentrations of the PYY has been detected both fasting and postprandially. The effect of the MGB on the PYY levels did not differ from the RYGB group outcomes. CONCLUSIONSː The results of our study suggest similar endocrine and metabolic effects of MGB and RYGB procedures. Long-term efficacy and metabolic benefits of MGB require further research.

Superconductivity in CaBi2

Superconductivity is observed with critical temperature Tc = 2.0 K in self-flux-grown single crystals of CaBi2. This material adopts the ZrSi2 structure type with lattice parameters a = 4.696(1) Å, b = 17.081(2) Å and c = 4.611(1) Å. The crystals of CaBi2 were studied by means of magnetic susceptibility, specific heat and electrical resistivity measurements. The heat capacity jump at Tc is ΔC/γTc = 1.41, confirming bulk superconductivity; the Sommerfeld coefficient γ = 4.1 mJ mol(-1) K(-2) and the Debye temperature ΘD = 157 K. The electron-phonon coupling strength is λel-ph = 0.59, and the thermodynamic critical field Hc is low, between 111 and 124 Oe CaBi2 is a moderate coupling type-I superconductor. Results of electronic structure calculations are reported and charge densities, electronic bands, densities of states and Fermi surfaces are discussed, focusing on the effects of spin-orbit coupling and electronic property anisotropy. We find a mixed quasi-2D + 3D character in the electronic structure, which reflects the layered crystal structure of the material.

Antiferromagnetism and superconductivity in the half-Heusler semimetal HoPdBi

We observed the coexistence of superconductivity and antiferromagnetic order in the single-crystalline ternary pnictide HoPdBi, a plausible topological semimetal. The compound orders antiferromagnetically at TN = 1.9 K and exhibits superconductivity below Tc = 0.7 K, which was confirmed by magnetic, electrical transport and specific heat measurements. The specific heat shows anomalies corresponding to antiferromagnetic ordering transition and crystalline field effect, but not to superconducting transition. Single-crystal neutron diffraction indicates that the antiferromagnetic structure is characterized by the propagation vector. Temperature variation of the electrical resistivity reveals two parallel conducting channels of semiconducting and metallic character. In weak magnetic fields, the magnetoresistance exhibits weak antilocalization effect, while in strong fields and temperatures below 50 K it is large and negative. At temperatures below 7 K Shubnikov-de Haas oscillations with two frequencies appear in the resistivity. These oscillations have non-trivial Berry phase, which is a distinguished feature of Dirac fermions.

Pretransplantation use of the second-generation tyrosine kinase inhibitors has no negative impact on the HCT outcome

Introduction

Allogeneic hematopoietic cell transplantation (HCT) was a standard therapy in chronic phase (CP) chronic myeloid leukemia (CML). As a result of the effective therapy with tyrosine kinase inhibitors (TKI), HCT was shifted to defined clinical situations. We present the results of observational prospective analysis of 28 CML patients undergoing HCT after exposure to, at least, two lines of TKI (including dasatinib and/or nilotinib), with respect to response, overall survival (OS), treatment toxicity, graft versus host disease (GVHD), and progression/relapse incidence.

Results

All the patients but one engrafted with median time 19 days. OS for patients in CP1 and CP2/accelerated phase (AcP) were 92.9 and 85.7 %, respectively. Six patients allotransplanted in blast crisis (BC) CML died early after HCT.

Eighteen patients achieved deep molecular remission (MR^4.5 or MR^4.0). Relapse incidence was 29.6 %. Median time to progression (TTP) differs significantly depending on the CML phase prior to HCT, the best response achieved after HCT and development of chronic GvHD.

NRM yielded the values 7.1, 12.5, and 50 % in CP1, CP2/AcP, and BC, respectively. Fatal outcome, due to veno-occlusive disease (VOD), was observed in two (7 %) patients. In five (17.9 %) patients, mild or moderate VOD was observed with no negative impact of preceding therapy with TKI2. Acute GvHD was diagnosed in 25.9 % of patients, while chronic GvHD developed in 42.9 % of individuals.

Conclusion

Pretransplantation therapy with TKI2 in CP CML is safe and reasonable. In BC, the optimal approach before HCT is to reduce the leukemic burden and achieve subsequent CP.

Assessment of platelet function in endogenous hypercortisolism

INTRODUCTION

It is commonly known that glucocorticoids exert a significant effect on haemostasis. Studies that have analysed the plasmatic coagulation system and fibrinolysis parameters in hypercortisolaemic patients are abundant. Platelet function, which plays a vital role in primary haemostasis, is much less clear in this context. We aimed at assessing platelet function in endogenous hypercortisolaemic patients.

MATERIAL AND METHODS

Twenty-five hypercortisolaemic patients were included in the study. Twelve of them were diagnosed with overt Cushing's syndrome (OCS) and 13 had subclinical Cushing's syndrome (SCS). Thirty healthy volunteers comprised the control group. In all subjects platelet function parameters were examined: ADP- and collagen-induced platelet aggregation (ADP-IPA and Col-IPA, respectively), IMPACT R (expressed as percentage of surface covered (SC) by platelets and average size (AS) of the adhering particles in μm2), as well as closure time (CT) after platelet activation with agonists: ADP and Col or Col and epinephrine (EPI). The statistical significance level was set at 0.05.

RESULTS

There was no significant difference in mean values of ADP-IPA, Col-IPA, Col/Epi CT, Col/ADP CT, SC, and AS between hypercortisolaemic subjects and controls. No statistically significant differences in means of examined parameters were found between overt and subclinical Cushing's syndrome patients. Furthermore, no statistically significant relationships were found between these parameters and hormonal indicators of hypercortisolism: 24-hour urinary cortisol excretion, morning and evening serum cortisol level, and overnight-test cortisol concentration.

CONCLUSIONS

In hypercortisolaemic patients no primary haemostasis disorders are present, as reflected by platelet adhesion and ADP- and collagen-induced aggregation measurements.

Activity of selected coagulation factors in overt and subclinical hypercortisolism

It is universally acknowledged that glucocorticoids are hormones that exert a significant effect on hemostasis. The aim of this study was to analyze the activities of coagulation factors VIII, von Willebrand (vW), IX, X, and XI, in patients with overt and subclinical hypercortisolism, as well as to examine possible associations between activities of these factors and the degree of hypercortisolism. Thirty endogenous hypercortisolemic patients were included in the study. Twelve of them were diagnosed with overt Cushing's syndrome (OCS), and eighteen with subclinical Cushing's syndrome (SCS). Healthy, age- and sex-matched volunteers comprised the control group. Activities of coagulation factors VIII, IX, X, and XI were examined using a coagulometric method, and von Willebrand factor (vWF) using an immunoturbidimetric method. Mean activities of examined coagulation factors were significantly higher in OCS patients in comparison to healthy controls. SCS patients had significantly higher mean vWF activities versus controls; and a clear trend toward higher mean activities of other factors in SCS patients versus controls was recorded (but no significant differences). Furthermore, statistically significant positive correlations were found between activities of factor IX and: morning serum cortisol concentrations, 24-hour urinary cortisol excretion values, cortisol concentrations in the overnight suppression test with 1 mg of dexamethasone. Activities of factors X and XI positively correlated with cortisol levels in the overnight suppression test. In endogenous hypercortisolemic patients the coagulation pathway is hyperactivated as indicated by increased activities of coagulation factors. These disorders are evident among patients with overt hypercortisolism.