Coexistence of Addison-Biermer's anaemia with endocrine glands' dysfunctions

Addison-Biermer's anaemia is an autoimmune disease. It may coexist with other auto-aggressive diseases, precede them or join the other existing autoimmune diseases. It most often accompanies the Hashimoto disease but also may coexist polyglandular autoimmune syndrome (PGA). Three types of PGA are distinguished: PGA1--Blizzard's Syndrome, PGA2--Schmidt's Syndrome, and PGA3. The latter, unlike the remaining ones, is characterized by normal function of adrenal glands. Addison-Biermer's anaemia occurrence may be often difficult to diagnose as coexisting illnesses might ouflage its clinical symptoms. The aim of this paper was to analyse patients with different types of PGA with coexisting Addison-Biermer's anaemia. Group of 24 individuals was analysed: 2 women with PGA1, 10 patients with PGA2, 10 patients with PGA3. In 2 remaining ones PGA was not confirmed. Addison-Biermer's anaemia occurred in 7 patients (2 with PGA2 and 5 with PGA3 syndrome). Decreased concentration of vitamin B12 was diagnosed in 3 individuals among 24 examined patients (1 with type 3 and 2 with type 2), as well in 2 patients with unconfirmed PGA. Addison-Biermer's anaemia was not observed in patients with PGA1. We observed that megaloblastic anaemia occurred characteristic schedule depending on appearance of autoimmune diseases: in PGA2--many years after other immunopathies were found, in PGA3--as first auto-aggressive disease. Our analysis suggests the necessity of detailed check-ups on patients with Addison-Biermer's anaemia, as with time they may develop other diseases, especially hypothyroidism and/or PGA failure. On the contrary, in individuals with thyroid gland diseases and PGA syndromes further checkups should be megaloblastic anaemia-sensitive. In both cases it is important to consider substitutive treatment. The possibility of family coexisting both pernicious anaemia and autoimmune endocrinopathies needs diagnostics of members of the patient's family.     

Some aspects of pharmacotherapy of tinnitus. Compound therapy with Xylocaine and directive counseling--long-term results

29 out of 49 patients, who were treated in 1996-1998 with Xylocaine and directive counselling for their tinitus, were reevaluated. Non of the patients used any other pharmacological treatment of the tinnitus or underwent full tinnitus retraining therapy (TRT) since 10-days treatment with Xylocaine had been completed. Initially 65.3% of patients declared improvement in their tinnitus. After over 5 years of observation success rate decreased to only 41.3%. Since the positive effect of 10-days treatment with Xylocaine and directive counselling was not stable we concluded that tinnitus patients should receive full TRT.     

Cysteine proteases as disease markers

This review comprises issues concerning cysteine cathepsins (CCs): human peptidases belonging to papain family (C1) of clan CA of cysteine proteases: cathepsins B, L, H, S, K, F, V, X, W, O and C. The involvement of these enzymes in physiological and pathological processes is described, especially with respect to their application as diagnostic and prognostic markers. They participate in precursor protein activation (including proenzymes and prohormones), MHC-II-mediated antigen presentation, bone remodeling, keratinocytes differentiation, hair follicle cycle, reproduction and apoptosis. Cysteine cathepsins upregulation has been demonstrated in many human tumors, including breast, lung, brain, gastrointestinal, head and neck cancer, and melanoma. Besides cancer diseases, they have been implied to participate in inflammatory diseases, such as inflammatory myopathies, rheumatoid arthritis, and periodontitis. Also, certain hereditary disorders are connected with mutations in CCs genes, what is observed in pycnodysostosis resulted from catK gene mutation and Papillon-Lefevre and Haim-Munk syndrome caused by catC gene defect. The potential application of cysteine cathepsins in diagnosis and/or prognosis is discussed in cancer diseases (breast, lung, head and neck, ovarian, gastrointestinal cancers, melanoma), as well as other disorders (periodontitis, rheumatoid arthritis, osteoarthritis).     

Incidence of congenital malformations and neonatal mortality in children born at the Regional Hospital in Brzeziny in years 1990-2001

The aim of the study was to estimate the incidence of congenital malformations and neonatal mortality rate in children born in our hospital from 1990 to 2001, taking into account the effects of low birth weight and premature delivery. We investigated medical documentation of 5496 children born during the analyzed period. Presence of major and minor malformations and survival through the neonatal period were determined for each subject. Among newborns with low birth weight 8.3% were born with congenital malformations, among those born preterm--12.1%. The major malformations were 3 times more often in children with low birth weight and 4 times more often in children born prematurely. In our cohort the mortality of 0.2% was observed. Congenital defects, followed by the complications of preterm delivery, were the predominant causes of natal death. Deaths due to congenital defects occurred twice as often as the deaths caused by prematurity complications. The congenital malformations mortality in newborns with congenital malformations reached 4.8%. The majority of congenital defects deaths were caused by central nervous system defects, chromosomal aberrations and multiple congenital malformations.     

Expected change of direction in Polish law regarding cosmetics

In connection with adaptation of Polish law to UE regulations, new Polish Act on cosmetics was published. There were also prepared regulations concerning: lists the substances forbidden to be used in cosmetics, permitted to be used in cosmetics only with restrictions, allowed colouring agents, preservatives and UV filters, rules of non-inclusion of one or more ingredients on the list used for the labelling, establishing National System for Informing about Cosmetics and methods of analysis necessary for checking the composition of cosmetic products. Publication in Official Journal of the European Union L. 66/26 Directive 2003/15/EC shows direction necessary changes in Polish Act on cosmetics.     

Lactational amenorrhea as a method of family planning in Egypt

Because of the potential importance of the lactational amenorrhea method (LAM) as a family-planning option in Egypt, we analyzed data from the 1995 Egyptian Demographic and Health Survey (EDHS) to study breastfeeding practices, use of contraception, reproductive history and sociodemographic factors for 5504 mothers with children under 3 years. According to the EDHS data, about 80% of Egyptian women breastfed for at least 6 months, and 40% breastfed for 15-18 months. Over half of breastfeeding mothers used no additional contraception. Thirty-six percent of mothers breastfeeding children younger than 6 months who reported using no additional contraception were exclusively breastfeeding and amenorrheic, but only 4% reported relying on breastfeeding for family planning. We also held eight focus group discussions with breastfeeding mothers from urban and rural Upper and Lower Egypt on their use of contraceptive methods, breastfeeding, lactational amenorrhea and LAM. Participants showed strong recognition of the contraceptive effects of breastfeeding but differed widely in their understanding of lactational infecundability and knowledge of LAM as a method. These results suggest that LAM would be widely acceptable to Egyptian women, but that an educational program about the method is needed.     

A novel highly pathogenic Alzheimer presenilin-1 mutation in codon 117 (Pro117Ser): Comparison of clinical, neuropathological and cell culture phenotypes of Pro117Leu and Pro117Ser mutations

A novel presenilin-1 (PS1) mutation (P117S) in an American pedigree is described. We compare clinical, neuropathological and cell culture phenotypes produced by this mutation with another codon 117 mutation that was earlier discovered by our group in a Polish kindred. Both mutations are associated with an unusually severe Alzheimer disease (AD) phenotype, with the onset starting before the third decade of life, rapid disease progression and acute presentation of clinical symptoms. The severity of clinical phenotype was closely correlated with the abundance of pathology: massive deposition of Abeta42 in plaques, severe neurofibrillary degeneration and neuronal loss. When overexpressed in mouse neuroblastoma N2a cells, both mutations caused loss of an ability to promote neurite outgrowth and produced an increase in the ratio of secreted Abeta42/40 amyloid peptides. In stably transfected N2a cell lines only mutant proteins were endoproteolytically cleaved indicating some dependability of this process on the presence of mutation. Taken together, our results show that clinical and cell culture phenotypes produced by these 2 codon 117 mutations are closely related suggesting that the pathogenic action of PS1 may involve effect on neurite outgrowth and endoproteolytic cleavage of the full-length protein. Given the high potency in vivo and in vitro of both codon 117 mutations, this site of PS1 must be particularly important for its normal/pathogenic function.     

Assessment of the midwives preparation to take care of patients with cervical cancer

INTRODUCTION: The success of the cervical cancer treatment depends not the only on the early diagnosis, but also on the immediate initiation of the appropriate treatment and proper nursing care, which should be adequate with the present knowledge. OBJECTIVE: The objective of the research was the assessment of the theoretical preparation of nurses taking care of patients with cervical cancer. MATERIALS AND METHOD: 50 nurses, working in the departments of gynecological diseases, have been interviewed. All the nurses graduated from College of Nursing, 3 of them additionally studied in the Pedagogical Graduate School. 60% of the nurses had 10-20 years of professional experience. We used special questionnaire made of 3 parts: describing the objective of the research/test, characteristics of the patient, specific questions. There were 18 questions: 5-closed, 1-open, 12-semiopen. They were checking the knowledge about the diagnostics, preparation of the patient to the operation using Wertheim-Meigs-Valle method, postoperative care until the discharge from the hospital and then oncological care. RESULTS: Almost all of them (88%-92%) have known the sequence of the diagnosis and treatment of the cervical cancer. 90% of them have been knowledgeable what kind of diagnostic and nursing procedures were required before the surgery using Wertheim-Meigs-Valle method. Almost all of the tested nurses (96%-100%) have known the procedure of postoperative care. They had a practical knowledge how to assess the patient condition and components of care that the patients require during the first few days after the surgery. According to the tested nurses, 90% of the patients operated because of cervical cancer, should follow up in oncological centers. CONCLUSION: 1. The nurses' preparation to take care of patients with cervical cancer is sufficient and it affects the effectiveness of the treatment. 2. The nurses have knowledge about pre- and postoperative procedures that the patients require, as well as assessment of general condition and patients' care, which are so important in the first few days after the surgery.