Radosław Sierpiński

AIMS: Iron deficiency (ID) is frequent in heart failure (HF), linked with exercise intolerance and poor prognosis. Intravenous iron repletion improves clinical status in HF patients with left ventricular ejection fraction (LVEF) ≤45%. However, uncertainty exists about the accuracy of serum biomarkers in diagnosing ID. The aims of this study were (i) to identify the iron biomarker with the greatest accuracy for the diagnosis of ID in bone marrow in patients with ischaemic HF, and (ii) to establish the prevalence of ID using this biomarker and its prognostic value in HF patients. METHODS AND RESULTS: Bone marrow was stained for iron in 30 patients with ischaemic HF with LVEF ≤45% and 10 healthy controls, and ID was diagnosed for 0-1 grades (Gale scale). A total of 791 patients with HF with LVEF ≤45% were prospectively followed up for 3 years. Serum ferritin, transferrin saturation, soluble transferrin receptor (sTfR) were assessed as iron biomarkers. Most patients with HF (n = 25, 83%) had ID in bone marrow, but none of the controls (P < 0.001). Serum sTfR had the best accuracy in predicting ID in bone marrow (area under the curve 0.920, 95% confidence interval 0.761-0.987, for cut-off 1.25 mg/L sensitivity 84%, specificity 100%). Serum sTfR was ≥1.25 mg/L in 47% of HF patients, in 56% and 46% of anaemics and non-anaemics, respectively (P < 0.05). The reclassification methods revealed that serum sTfR significantly added the prognostic value to the baseline prognostic model, and to the greater extent than plasma N-terminal pro B-type natriuretic peptide. Based on internal derivation and validation procedures, serum sTfR ≥1.41 mg/L was the optimal threshold for predicting 3-year mortality, independent of other established variables. CONCLUSIONS: High serum sTfR accurately reflects depleted iron stores in bone marrow in patients with HF, and identifies those with a high 3-year mortality.

INTRODUCTION: The coronavirus disease 2019 (COVID 19) is a communicable disease caused by a novel coronavirus. OBJECTIVES: This study aimed to assess self‑reported frequency of gastrointestinal symptoms and olfactory or taste disorders in nonhospitalized patients with COVID‑19 in Poland. PATIENTS AND METHODS: This cross‑sectional survey was conducted between April 17 and 18, 2020, in 4516 nonhospitalized patients with COVID‑19 in Poland. The questionnaire included 8 questions related to the health status, symptoms of COVID‑19, comorbidities, and smoking status. RESULTS: Completed questionnaires were obtained from 1942 patients with COVID‑19 with a response rate of 43%. The median age of the respondents was 50 years; 60.2% were women. Among nonhospitalized patients with COVID‑19, 21.3% had hypertension, 4.5% had diabetes, and 3.1% had a chronic respiratory disease. Regular tobacco use was declared by 11.2% of patients with COVID‑19. At least one gastrointestinal symptom was reported by 53.6% of patients. Almost half of patients (47%) with COVID‑19 reported lack of appetite and 24.2% reported diarrhea. Among 1942 interviewed patients, 54.2% reported at least 1 olfactory or taste disorder and 42.5% reported both alterations. Self‑reported olfactory and taste disorders were 49.2% and 47.5%, respectively. Self‑reported frequency of gastrointestinal symptoms and olfactory or taste disorders during COVID‑19 was significantly higher (P <0.001) in women than men. CONCLUSIONS: This study demonstrated that olfactory and taste disorders are frequent symptoms in patients with mild‑to‑moderate COVID‑19. Moreover, our study indicated sex differences in the frequency of gastrointestinal symptoms and olfactory or taste disorders among nonhospitalized patients with COVID‑19.

Blood malignancies remain a therapeutic challenge despite the development of numerous treatment strategies. The phosphatidylinositol-3 kinase (PI3K)/protein kinase B/mammalian target of rapamycin (PI3K/Akt/mTOR) signaling pathway plays a central role in regulating many cellular functions, including cell cycle, proliferation, quiescence, and longevity. Therefore, dysregulation of this pathway is a characteristic feature of carcinogenesis. Increased activation of PI3K/Akt/mTOR signaling enhances proliferation, growth, and resistance to chemo- and immunotherapy in cancer cells. Overactivation of the pathway has been found in various types of cancer, including acute and chronic leukemia. Inhibitors of the PI3K/Akt/mTOR pathway have been used in leukemia treatment since 2014, and some of them have improved treatment outcomes in clinical trials. Recently, new inhibitors of PI3K/Akt/mTOR signaling have been developed and tested both in preclinical and clinical models. In this review, we outline the role of the PI3K/Akt/mTOR signaling pathway in blood malignancies' cells and gather information on the inhibitors of this pathway that might provide a novel therapeutic opportunity against leukemia.

Systematic collection of mortality/morbidity data over time is crucial for monitoring trends in population health, developing health policies, assessing the impact of health programs. In Poland, a comprehensive analysis describing trends in disease burden for major conditions has never been published. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides data on the burden of over 300 diseases in 195 countries since 1990. We used the GBD database to undertake an assessment of disease burden in Poland, evaluate changes in population health between 1990-2017, and compare Poland with other Central European (CE) countries.

INTRODUCTION: Coronavirus disease 2019 (COVID‑19) is an infectious disease caused by the novel severe acute respiratory syndrome coronavirus 2. OBJECTIVES: Our aim was to present an epidemiological analysis of the first 2 months (March and April 2020) of the COVID‑19 epidemic in Poland. PATIENTS AND METHODS: This analysis was based on data from epidemiological reports collected between March 4 and April 30, 2020, by the Chief Sanitary Inspectorate. These epidemiological reports include data on sociodemographic characteristics of new laboratory‑confirmed COVID 19 cases, the number of COVID‑19-related deaths, the number of recovered COVID-19 patients as well as the number of laboratory tests performed. RESULTS: From March 4 to April 30, 2020, a total of 12 877 laboratory‑confirmed COVID 19 cases were registered in Poland (55.7% women; mean [SD] age, 50.6 [20.5] years). The RT‑ PCR test was performed in 338 000 patients. The notification rate for COVID‑19 was 33.2 per 100 000 inhabitants. One third of laboratory‑confirmed COVID 19 cases were among quarantined persons, 26.1% were related to the healthcare system (hospital or clinic), and 13.3% occurred in nursing homes. As of April 30, 2020, 644 COVID‑19-related deaths were registered in Poland (46.5% women). The death rate for the whole country was 1.7 per 100 000 inhabitants. CONCLUSIONS: Our data showed higher notification rate for COVID‑19 among women than men, but men were more likely to die from COVID‑19. The notification rate for COVID-19 in Poland among women aged 45 to 54 years was 2‑fold higher than among men.