Role of endoscopic ultrasound in the characterization of solid pseudopapillary neoplasm of the pancreas

BACKGROUND Solid pseudopapillary neoplasm(SPN) is an uncommon pathology of the pancreas with unpredictable malignant potential. Endoscopic ultrasound(EUS) assessment plays a vital role in lesion characterization and confirmation of the tissue diagnosis. However, there is a paucity of data regarding the imaging assessment of these lesions.AIM To determine the characteristic EUS features of SPN and define its role in preoperative assessment.METHODS This was an international, multicenter, retrospec...     

Malnutrition in Obesity: Is It Possible?

BackgroundThe World Health Organization (WHO) classifies malnutrition as the biggest threat to public health worldwide, and this condition is observed in 20–60% of hospitalized patients. Malnutrition is a state of the body in which due to insufficient supply or incorrect absorption of essential nutrients, the body composition changes and the body''s functions are impaired. Malnutrition is associated not only with reduced body mass index but also with obesity.SummaryObesity is defined as a paradoxical state of malnutrition, which despite excessive energy consumption is associated with a shortage of individual microelements. Deficiency or lack of homeostasis of essential micronutrients can significantly affect daily performance, intellectual and emotional state, but also the physical state of the body. Food deficiency can also contribute to further weight gain or the development of other metabolic diseases. Micronutrient deficiency may include not only incorrect dietary choices and insufficient access to nutrient-rich foods but also changes in the absorption, distribution or excretion of nutrients, and altered micronutrient metabolism resulting from systemic inflammation caused by obesity. An effective therapy method recommended for people with morbid obesity is bariatric surgery aimed at both weight loss and improving quality of life. Unfortunately, the effects of these treatments are often medium- and long-term complications associated with micronutrient deficiency as a result of reduced consumption or absorption. Therefore, the use of bariatric surgery in patients with extreme obesity can affect the metabolism of microelements and increase the risk of nutritional deficiencies.Key MessagesStudies by many authors indicate a higher incidence of food deficiency among people with excessive body weight, than in people with normal body weight of the same age and same sex. Monitoring the concentration of minerals and vitamins in blood serum is a good practice in the treatment of obesity. The proper nutritional status of the body affects not only the state of health but also the effectiveness of therapy. The aim of the review was to present the issue of malnutrition in the context of obesity.     

Novel Sensitizing Agent Formulation for Bulk Emulsion Explosives with Improved Energetic Parameters

Bulk emulsion explosives, although they are very convenient and safe to use, also have disadvantages, with the main one being the relatively low power in relation to cartridged emulsion explosives or classic nitroesters (e.g., dynamites). Therefore, materials of this type currently have only limited use. In addition, these materials are characterized by the variability of blasting parameters over time from loading into the blasthole, which is closely dependent on the utilised mining method of the mine, which makes it difficult to precisely control the fragmentation. The industry is trying to respond to the demand for bulk emulsion explosives with increased energy and improved parameter stability, but so far it has not been possible to do so in a safe and effective way. Methods of improving blasting parameters mainly rely on additives to oxidant solutions during production, which creates additional risks at the production stage, as it involves handling hot and concentrated ammonium nitrate solutions, for which there are known cases of uncontrolled decomposition of such solutions, even leading to an explosion. This paper presents a method of improving the thermodynamic parameters and the stability of the sensitization reaction without the need for changes in the oxidant solution.     

Horse-Specific Cryptosporidium Genotype in Human with Crohn's Disease and Arthritis

We identified an unusual subtype of a Cryptosporidium sp. horse genotype as the cause of cryptosporidiosis in a 13-year-old girl in Poland who was undergoing immunosuppressive treatment for juvenile rheumatoid arthritis and Crohn’s disease. The same subtype was identified in a horse the girl had ridden.     

Electropolymerized Aniline-Based Stainless Steel Fiber Coatings Modified by Multi-Walled Carbon Nanotubes for Electroanalysis of 4-Chlorophenol

In this paper, a stainless steel fiber coated electropolymerized aniline, without and with carbon nanotubes (SS/PANI and SS/PANI/CNT), along with CNTs modified carbon paste electrodes (CPEs), were prepared. The electrodes were characterized by differential pulse voltammetry (DPV) and applied for the detection of 4-chlorophenol (4-CP). For all the electrodes, the oxidative peak current showed a linear dependence on the 4-CP concentration in the range of 0.05–0.5 mmol/L with R² ≥ 0.991. SS/PANI/CNT electrodes showed greater sensitivity for the detection of the 4-CP than the SS/PANI and CPEs. For all of the aniline-based stainless steel electrodes, both the LOD and LOQ decreased with the increase in the number of electropolymerization cycles. The lowest LOD (0.38 µmol/L) and LOQ (1.26 µmol/L) were observed for the SS/PANI/CNT electrode modified in aniline solution during 30 cycles. The methods were successfully applied to the analysis of 4-CP in real samples (tap water and river water). The results demonstrated the good agreement of the added and found concentrations of the 4-CP. The recovery and precision were from 95.12% to 102.24% and from 1.53% to 6.79%, respectively. The proposed electrodes exhibited acceptable reproducibility, admirable stability, and adequate repeatability and showed potential for the analysis of 4-CP in water.     

Health Safety Assessment of Ready-to-Eat Products Consumed by Children Aged 0.5–3 Years on the Polish Market

Toxic elements have a negative impact on health, especially among infants and young children. Even low levels of exposure can impair the normal growth and development of children. In young children, all organs and metabolic processes are insufficiently developed, making them particularly vulnerable to the effects of toxic elements. The aim of this study is to estimate the concentration of toxic elements in products consumed by infants and young children. The health risk of young children due to consumption of ready-made products potentially contaminated with As (arsenic), Cd (cadmium), Hg (mercury), and Pb (lead) was also assessed. A total of 397 samples (dinners, porridges, mousses, snacks “for the handle”, baby drinks, dairy) were analyzed for the content of toxic elements. Inductively coupled plasma mass spectrometry (ICP-MS) was used to assess As, Cd, and Pb concentration. The determination of Hg was performed by atomic absorption spectrometry (AAS). In order to estimate children’s exposure to toxic elements, the content of indicators was also assessed: estimated daily intake (EDI), estimated weekly intake (EWI), provisional tolerable weekly intake (PTWI), provisional tolerable monthly intake (PTMI), the benchmark dose lower confidence limit (BMDL), target hazard quotient (THQ), hazard index (HI), and cancer risk (CR). The average content of As, Cd, Hg, and Pb for all ready-made products for children is: 1.411 ± 0.248 µg/kg, 2.077 ± 0.154 µg/kg, 3.161 ± 0.159 µg/kg, and 9.265 ± 0.443 µg/kg, respectively. The highest content As was found in wafer/crisps (84.71 µg/kg); in the case of Cd, dinners with fish (20.15 µg/kg); for Hg, dinners with poultry (37.25 µg/kg); and for Pb, fruit mousse (138.99 µg/kg). The results showed that 4.53% of the samples attempted to exceed Pb, and 1.5% exceeded levels of Hg. The highest value of THQ was made in the case of drinks, for Cd and Pb in mousses for children, and Hg for dairy products. The THQ, BMDL, and PTWI ratios were not exceeded. The analyzed ready-to-eat products for children aged 0.5–3 years may contain toxic elements, but most of them appear to be harmless to health.     

KIM-1 and NGAL: new markers of obstructive nephropathy

Congenital obstructive nephropathy is the primary cause of chronic renal failure in children. Rapid diagnosis and initiation of the treatment are vital to preserve function and/or to slow down renal injury. The aim of our study was to determine whether urinary (u) kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) may be useful non-invasive biomarkers in children with congenital hydronephrosis (HN) caused by ureteropelvic junction obstruction. The study cohort consisted of 20 children with severe HN who required surgery (median age 2.16 years) and two control groups (control group 1: 20 patients with mild, non-obstructive HN; control group 2: 25 healthy children). All of the children had normal renal function. Immunoenzymatic ELISA commercial kits were used to measure uKIM-1 and uNGAL concentrations. The preoperative median uKIM-1/creatinine (cr.) and uNGAL levels were significantly greater in the children with severe HN than in both control groups. Three months after surgery, uNGAL had decreased significantly (p < 0.05) in the children with severe HN, but was still higher than that in control group 2 children (p < 0.05). Receiver operator characteristic analyses revealed a good diagnostic profile for uKIM-1 and uNGAL in terms of identifying a differential renal function of <40% in HN patients (area under the curve (AUC) 0.8 and 0.814, respectively) and <45% in all examined children (AUC 0.779 and 0.868, respectively). Based on these results, we suggest that increasing uNGAL and uKIM-1 levels are associated with worsening obstruction. Further studies are required to confirm a potential application of uKIM-1 and uNGAL as useful biomarkers for the diagnosis and progression of chronic kidney disease.     

Neutrophil infiltration combined with necrosis in the primary tumor is a useful prognostic indicator for three-year disease-free survival time in patients with colorectal cancer

Histopathological evaluation plays a key role in the diagnosis of colorectal cancer (CRC). Tumor-related local inflammation is regarded as a novel prognostic parameter. Neutrophils constitute one of the main types of inflammatory cells. The aim of the present study was to evaluate the prognostic value of intratumoral tumor-associated neutrophils (intraTANs), stromal TANs (stromaTANs) and necrosis, as well as their combined parametric value in formalin-fixed paraffin-embedded tissue sections from patients with CRC. For this purpose, a retrospective study of 160 patients with CRC who underwent surgery was conducted. The association of intraTANs, stromaTANs, necrosis and their combined parametric value with the clinicopathological features of patients with CRC was examined. The Kaplan-Meier method and the log-rank test were used to compare survival curves. To identify independent prognostic factors, uni- and multivariate Cox proportional hazards regression models were used. StromaTANs were associated with lymph node metastasis (P=0.049) and tumor deposits (P=0.041). In addition, necrosis was found to be associated with venous (P=0.003), lymphatic (P=0.007) and perineural (P=0.015) invasion, as well as with lymph node metastasis (P=0.033), the number of invaded lymph nodes (P=0.012), and lymph node pouch invasion (P=0.043). Furthermore, necrosis was found to be associated with the white blood cell count (P=0.030), neutrophil count (P=0.011), the combined neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (NLR-PLR) (P=0.038), and the combined platelet and NLR (PLT-NLR status) (P=0.030), as well as with the serum carcinoembryonic antigen (CEA) levels following surgery (P=0.011) and the monocyte-to-lymphocyte ratio (P=0.023). The combined parametric value was found to be associated with pT stage (P=0.049), venous (P=0.034) and lymphatic (P=0.026) invasion, and with serum CEA levels prior to surgery (P=0.029). The analysis of the 3-year disease-free survival (DFS) time revealed that tumor growth [hazard ratio (HR), 2.070; 95% CI, 1.837-3.808; P=0.003] and the combined parametric value (intraTANs, stromaTANs and necrosis, HR, 1.577; 95% CI, 1.372-3.032; P=0.028) were independent factors for patients with CRC. Taken together, the findings of the present study demonstrated that the combined value of neutrophils and necrosis examined in the cancerous tissue may be used as a prognostic factor for the 3-year DFS time in patients with CRC.     

Musculoskeletal manifestations of Lyme borreliosis – a review

Lyme borreliosis (LB) is a zoonotic disease caused by Gram-negative bacteria Borrelia burgdorferi sensu lato. The majority of reported cases of LB originate in the northern hemisphere, mostly in the US and Europe. One of the typical manifestations of LB are musculoskeletal symptoms; they may appear in any of the three LB stages. The diagnosis is based on clinical manifestations and confirmed by serological tests. One course of antibiotic therapy is sufficient for LB to dissipate in most cases, although for some patients, the symptoms subside gradually even after completion of therapy. Patients who have been demonstrated to have specific antibodies but are symptomless should not be treated. In instances where the advised treatment proved to be unsuccessful, patients should be referred to rheumatologist for additional diagnostics. The goal of this review is to update physicians on current scientific knowledge on musculoskeletal manifestations of LB.