Marianna Janion

INTRODUCTION There are limited data on the current prevalence of overweight and obesity as well as its changes with time in Poland. OBJECTIVES The aim of the study was to assess the prevalence of general and abdominal obesity and overweight in Polish adults in the years 2013-2014, and to compare it with the prevalence in the years 2003-2005. PATIENTS AND METHODS The study was conducted in 2 independent, representative samples of the Polish population, comprising 14 537 persons (aged 20-74 years) examined in the years 2003-2005 and 6164 persons (aged ≥20 years) examined in the years 2013-2014. Anthropometric measurements were done by trained nurses. RESULTS In the years 2013-2014, the age-standardized prevalence of obesity (body mass index [BMI] ≥30 kg/m2) was 24.4% in men and 25.0% in women. The prevalence of overweight (BMI, 25.0-29.9 kg/m2) was 43.2% in men and 30.5% in women. Abdominal obesity (waist circumference ≥102 cm in men or ≥88 cm in women) was noted in 32.2% of men and 45.7% of women. Abdominal overweight (waist circumference, 94-101.9 cm in men or 80-87.9 cm in women) was present in 27.2% of men and 21.7% of women. Since the years 2003-2005, the distribution of body mass according to the BMI category had shifted to higher values, and an increase in the prevalence of obesity was observed in men. The percentage of adults with normal waist circumference decreased significantly in both sexes. CONCLUSIONS Every fourth inhabitant of Poland is obese, and during the last decade, the prevalence of obesity has increased, particularly in men. Abdominal obesity is observed in every third man and nearly every second woman, and an excess of abdominal fat has increased in both sexes.

BACKGROUND: Lead-dependent tricuspid dysfunction (LDTD) is one of important complications in patients with cardiac implantable electronic devices. However, this phenomenon is probably underestimated because of an improper interpretation of its clinical symptoms. The aim of this study was to identify LDTD mechanisms and management in patients referred for transvenous lead extraction (TLE) due to lead-dependent complications. METHODS: Data of 940 patients undergoing TLE in a single center from 2009 to 2011 were assessed and 24 patients with LDTD were identifi ed. The general indications for TLE, pacing system types and lead dwell time in both study groups were comparatively analyzed. The radiological and clinical effi cacy of TLE procedure was also assessed in both groups with precision estimation of clinical status patients with LDTD (before and after TLE). Additionally, mechanisms, concomitant lead-dependent complications and degree (severity) of LDTD before and after the procedure were evaluated. Telephone follow-up of LDTD patients was performed at the mean time 1.5 years after TLE/replacement procedure. RESULTS: The main indications for TLE in both groups were similar (apart from isolated LDTD in 45.83% patients from group I). Patients with LDTD had more complex pacing systems with more leads (2.04 in the LDTD group vs. 1.69 in the control group; p = 0.04). There were more unnecessary loops of lead in LDTD patients than in the control group (41.7% vs. 5.24%; p = 0.001). There were no signifi cant differences in average time from implantation to extraction and the number of preceding procedures. Signifi cant tricuspid regurgitation (TR-grade III-IV) was found in 96% of LDTD patients, whereas stenosis with regurgitation in 4%. The 10% frequency of severe TR (not lead dependent) in the control group patients was observed. The main mechanism of LDTD was abnormal leafl et coaptation caused by: loop of the lead (42%), septal leafl et pulled toward the interventricular septum (37%) or too intensive lead impingement of the leafl ets (21%). LDTD patients were treated with TLE and reimplantation of the lead to the right ventricle (87.5%) or to the cardiac vein (4.2%), or surgery procedure with epicardial lead placement following ineffective TLE (8.3%). The radiological and clinical effi cacy of TLE procedure was very high and comparable between the groups I and II (91.7% vs. 94.2%; p = 0.6 and 100% vs. 98.4%; p = 0.46, respectively). Repeated echocardiography showed reduced severity of tricuspid valve dysfunction in 62.5% of LDTD patients. The follow- -up interview confi rmed clinical improvement in 75% of patients (further improvement after cardiosurgery in 2 patients was observed). CONCLUSIONS: LDTD is a diagnostic and therapeutic challenge. The main reason for LDTD was abnormal leafl et coaptation caused by lead loop presence, or propping, or impingement the leafl ets by the lead. Probably, TLE with lead reimplantation is a safe and effective option in LDTD management. An alternative option is TLE with omitted tricuspid valve reimplantation. Cardiac surgery with epicardial lead placement should be reserved for patients with ineffective previous procedures.

AIMS: Clinical outcomes in the treatment of acute ST-segment elevation myocardial infarction (STEMI) differ between men and women. The aim of the study was to compare results of STEMI management in a large multicentre national registry. METHODS AND RESULTS: A total of 456 hospitals (including 58 interventional centres) participated in the registry during one year. The study group consisted of 8,989 (34.5%) females and 17,046 (65.5%) males. Women were older (69.7 ± 11 vs. 62 ± 12 years; p<0.0001) and had more risk factors. Percutaneous coronary intervention was performed significantly less in women (47.8% vs. 57.4%; p<0.0001). There was a longer time delay in women at each stage of treatment. The incidence of in-hospital complications was higher in women. In-hospital (11.9% vs. 6.9%; p<0.0001) and 12-months (22% vs. 14.1%; p<0.0001) mortality was significantly higher in women. In multivariate analysis pulmonary oedema, cardiogenic shock, cardiac arrest, age, diabetes and anterior infarction significantly increased both in-hospital and long-term mortality. The in-hospital mortality was higher in the female group. CONCLUSIONS: Despite poor clinical characteristics, less than satisfactory management and a worse prognosis of STEMI in women, being a women itself is not a risk factor for increased long-term mortality, however, other well known risk factors affecting the prognosis relate frequently to the female gender.

BACKGROUND: Even with considerable improvement in treatment of epithelial ovarian cancer achieved in recent years, an increasing chemotherapy resistance and disease 5-year relapse is recorded for a majority part of patients that encourages the search for better therapeutic options. Gold nanoparticles (Au NPs) due to plethora of unique physiochemical features are thoroughly tested as drug delivery, radiosensitizers, as well as photothermal and photodynamic therapy agents. Importantly, due to highly controlled synthesis, it is possible to obtain nanomaterials with directed size and shape. METHODS: In this work, we developed novel elongated-type gold nanoparticles in the shape of nanopeanuts (AuP NPs) and investigated their cytotoxic potential against ovarian cancer cells SKOV-3 using colorimetric and fluorimetric methods, Western blot, flow cytometry, and fluorescence microscopy. RESULTS: Peanut-shaped gold nanoparticles showed high anti-cancer activity in vitro against SKOV-3 cells at doses of 1-5 ng/mL upon 72 hours treatment. We demonstrate that AuP NPs decrease the viability and proliferation capability of ovarian cancer cells by triggering cell apoptosis and autophagy, as evidenced by flow cytometry and Western blot analyses. The overproduction of reactive oxygen species (ROS) was noted to be a critical mediator of AuP NPs-mediated cell death. CONCLUSION: These data indicate that gold nanopeanuts might be developed as nanotherapeutics against ovarian cancer.

Nanotechnology-based therapeutic approaches have attracted attention of scientists, in particular due to the special features of nanomaterials, such as adequate biocompatibility, ability to improve therapeutic efficiency of incorporated drugs and to limit their adverse effects. Among a variety of reported nanomaterials for biomedical applications, metal and metal oxide-based nanoparticles offer unique physicochemical properties allowing their use in combination with conventional antimicrobials and as magnetic field-controlled drug delivery nanocarriers. An ever-growing number of studies demonstrate that by combining magnetic nanoparticles with membrane-active, natural human cathelicidin-derived LL-37 peptide, and its synthetic mimics such as ceragenins, innovative nanoagents might be developed. Between others, they demonstrate high clinical potential as antimicrobial, anti-cancer, immunomodulatory and regenerative agents. Due to continuous research, knowledge on pleiotropic character of natural antibacterial peptides and their mimics is growing, and it is justifying to stay that the therapeutic potential of nanosystems containing membrane active compounds has not been exhausted yet.