Search Results (14)

Background: The early identification of patients at risk of peri-procedural complications and poor prognosis is particularly important. We conducted our study to determine whether serum orexigenic neuropeptide Y (NPY) concentration is associated with nutritional status and prognosis among patients undergoing surgery for colorectal cancer (CRC). Materials and Methods: A cohort study with a 3-month follow-up was conducted with 84 consecutive inpatients who underwent elective surgery in one center between 2016 and 2019 for primary CRC. The clinical characteristics and nutritional status of all patients were assessed. In long-term follow-ups (median; IQR: 1322; 930–1788 days; average 3.6 years), the patients’ survival status was also checked during a telephone consultation. Results: Before CRC surgery, patients with serum NPY concentrations equal to or higher than the median value (661.70 pg/mL) had higher scores in their Mini Nutritional Assessment, Barthel, and Instrumental Activities of Daily Living (IADL) questionnaires, greater handgrip strength, a lower score in the Patient-Generated Subjective Global Assessment, and almost a three-times lower risk of perioperative complications, as well as higher Barthel and IADL scores and larger calf circumference at the 3-month follow-up visit in comparison to individuals with lower serum NPY concentrations. A higher serum NPY concentration was predictive of a low Nutritional Risk Screening 2002 score at the 3-month visit, and this was also found to have significantly influenced the patients’ survival during the 1200 days after CRC surgery. Conclusions: A higher preoperative serum NPY concentration may be related to lower nutritional risk, more favorable patient nutritional and functional status, and better survival, but further studies are required. Full article

The hemojuvelin–hepcidin regulatory axis may play a key role in the iron metabolism both systemically and locally. There is a pressing need to evaluate this tightly regulated network of iron parameters and their potential impact on the development of ischemic stroke (IS). We aimed to assess iron metabolism biomarkers in patients after IS, evaluating changes over time and considering their clinical features. We studied 45 patients diagnosed with IS. We assessed major iron metabolism parameters, such as hepcidin, soluble hemojuvelin (sHJV), soluble transferrin receptor (sTfR), and ferritin, using immunoenzymathic methods at two time points: on admission and on the 7th day post IS. We found increased ferritin levels on the 7th day post IS compared to admission, and this was observed in the entire study group (p = 0.03) and in the subgroup treated with thrombolysis (p = 0.02). The hepcidin levels, on the other hand, showed a significant decrease on the 7th day, though this difference was only evident in the entire study group (p = 0.04). We also discovered significantly elevated sHJV levels in patients with PACI stroke compared to other stroke locations, both on admission and on the 7th day post IS (p < 0.05). Significantly higher sHJV levels were observed in patients treated with thrombolysis compared to those receiving conventional treatment, regardless of the time point (p < 0.0001 and p = 0.0002, respectively). Our study revealed changes in the iron metabolism parameters during stroke. The patients with anterior cerebral infarction and those treated with thrombolysis presented significantly elevated sHJV levels. Full article

Background and Aims: In recent years, there has been a growing interest in factor XIII in ischaemic stroke. The study’s main aim was to assess the usefulness of factor XIII concentration determination in patients with acute ischaemic stroke (AIS) treated with thrombolysis with recombinant tissue plasminogen activator (t-PA). Methods: The study was conducted in two groups of 84 patients with AIS: group I—with thrombolytic therapy and group II—without thrombolysis. A physical examination, neurological status (using the National Institutes of Health Stroke Scale, NIHSS), daily patients’ activities measured with the Barthel Index and Modified Rankin Scale (mRS), and blood parameters were conducted on day 1 and day 7. The following parameters were assessed: highly sensitive C-reaction protein (CRP), fibrinogen, D-dimers (DD), neutrophil–lymphocyte ratio (NLR index), and the concentration of factor XIII-A. Results: In group I, the concentration of XIII-A decreased significantly between day 1 and 7 (p < 0.001). In group I, the concentration of XIII-A on day 7 in Total Anterior Circulation Infarct (TACI) was significantly lower than in non-TACI stroke. XIII-A concentration in group I was significantly lower in patients < 31 points with Acute Stroke Registry and Analysis of Lausanne (ASTRAL). A greater decrease in XIII-A between the first sampling on day 1 and the second sampling on day 7 was associated with a worse patient neurological state in group I. Conclusions: In patients with AIS treated with t-PA, factor XIII concentrations decrease in the acute phase of stroke, and the largest decrease occurs in the TACI stroke. Determination of factor XIII concentration in patients with AIS can be used in clinical practice as an additional parameter supporting the assessment of stroke severity and may play a role in the prognosis; lower factor XIII-A activity may be a predictor of a worse prognosis. Full article

(1) Background: Fire department cadets preparing to become firefighters and paramedics experience high levels of stress when participating in incidents like traffic accidents and fires. Stress adversely affects health, and coping with it proves difficult. Unfortunately, there is no single method that reduces stress completely in humans. One non-invasive method for lowering stress hormone levels is craniosacral therapy. (2) Methods: Fifty-seven firefighting cadets aged 18–24 years (21.63 ± 1.41) participated in the study. They were randomly assigned to either a test group or a control group. Participants’ blood levels of cortisol and CRH (corticotropin-releasing hormone) were assessed before and after the study. The study group underwent 5-week craniosacral therapy (1× per week). (3) Results: The Kruskal–Wallis test showed that the therapy group’s results were statistically significant for CRH values (p-value = 0.00067) and for cortisol values (p-value ≤ 0.0001). Wilxocon and Dunn tests showed statistical significance for cortisol after CS therapy between the control and study groups (p = 0.0377), and for CRH between the control and study groups before (p = 0.00634) and after the study (p = 0.000887), and in the study group before and after the study (p = 0.0101). (4) Conclusions: The application of craniosacral therapy reduced stress hormone levels in male firefighter cadets. The results indicate that craniosacral therapy (five sessions, one per week) has an effect on the reduction of stress hormones. Full article

Factor VII activating protease (FSAP) was first isolated from human plasma less than 30 years ago. Since then, many research groups have described the biological properties of this protease and its role in hemostasis and other processes in humans and other animals. With the progress of knowledge about the structure of FSAP, several of its relationships with other proteins or chemical compounds that may modulate its activity have been explained. These mutual axes are described in the present narrative review. The first part of our series of manuscripts on FSAP describes the structure of this protein and the processes leading to the enhancement and inhibition of its activities. The following parts, II and III, concern the role of FSAP in hemostasis and in the pathophysiology of human diseases, with particular emphasis on cardiovascular diseases. Full article

The health-promoting properties of Silybum marianum have been acknowledged since antiquity. This plant is credited with substantial hepatoprotective properties and is also protective in cardiovascular diseases, diabetes mellitus, and neurodegeneration, mainly for its anti-inflammatory and antioxidant effects. Only a few experimental studies have described the impact of Silybum marianum extract on the blood coagulation process; furthermore, these data are unsatisfactorily fragmented and need to be supplemented to understand the plant’s properties better. The predominant biologically active flavonolignan extracted from Silybum marianum is silybin, a mixture of two diastereomers, silybin A and silybin B, in approximately equimolar ratio. This study investigated the effect of silybin on the fundamental laboratory parameter for blood coagulation, namely prothrombin time (PT), an assay used to assess the extrinsic and common coagulation pathways. To evaluate the effect of silybin on PT, we prepared three solutions of silybin (Silybin (A + B mixture), PhytoLab GmbH & Co. KG, Vestenbergsgreuth, Germany) in 0.1% dimethylsulfoxide (DMSO, Sigma-Aldrich, Co., St. Louis, MO, USA): 10 μM, 50 μM, and 100 μM. PT was measured on a Coag 4D coagulometer (DIAGON Kft., Budapest, Hungary) using rabbit calcium thromboplastin (Dia-PT, DIAGON Kft., Budapest, Hungary) and control plasma, which is pooled plasma obtained from healthy donors (Dia-CONT, DIAGON Kft., Budapest, Hungary). A total of 10 µL of silybin solution was added to 40 µL of plasma; the sample was incubated for two minutes at 37 °C, and then 100 µL of thromboplastin, pre-warmed to 37 °C, and was added to the mixture. The coagulometer automatically gives the PT result in seconds (s). At the same time, PT was measured in the control plasma both without additional solutions and with the addition of tris-buffered saline (TBS) and 0.1% DMSO (10 µL of TBS or DMSO + 40 µL of plasma). Each measurement was performed eight times. Student’s t-test and the Friedman test with post-hoc analysis were used in the statistical analysis (Statistica 13, TIBCO Software Inc., Palo Alto, CA, USA). In the first step of our study, we tested how the dilution of the plasma sample affected PT. We did not observe statistically significant differences in PT between the control plasma and the control plasma supplemented with TBS (mean ± standard deviation 14.00 ± 0.77 s vs. 13.88 ± 0.38 s, p = 0.606). We also found no statistically significant differences in PT between the control plasma and the control plasma with the addition of 0.1% DMSO (mean ± standard deviation 14.00 ± 0.77 s vs. 14.10 ± 0.26 s, p = 0.728); therefore, we further analyzed the effect of silybin on PT using DMSO at this level (0.1%). The addition of silybin solutions to the control plasma resulted in a statistically significant PT-shortener (p < 0.001). Post-hoc analysis revealed a substantial shortening of PT under the influence of 50 μM (median 13.55 s) and 100 μM solution (median 13.40 s) of silybin, compared to plasma with the addition of 0.1% DMSO alone (median 14.10 s) and plasma with the addition of the lowest, 10 μM, level of silybin (median 14.20 s). At the same time, PT in the plasma with the addition of a 50 μM and 100 μM solution of silybin did not significantly differ statistically. Our in vitro analysis characterized the possible effect of Silybum marianum on the blood coagulation process. These results require further investigation to validate their validity and clinical utility. Full article

Objective: Iron overload (IO) is a common and life-threatening complication resulting from the therapy of AL and HCT patients. This study aimed to evaluate the prognostic value of 12 serum biomarkers of iron metabolism in pediatric patients treated for AL or undergoing HCT. Patients: Overall, 50 patients with AL after intensive treatment and 32 patients after HCT were prospectively included in the study. AL patients at diagnosis and healthy controls served as reference groups. Methods: The impact of the following 12 serum iron metabolism parameters on the outcome of AL/HCT patients was analyzed: iron, transferrin (Tf), total iron-binding capacity (TIBC), ferritin, ferritin heavy chains (FTH1), ferritin light chains (FTL), hepcidin, soluble hemojuvelin (sHJV), soluble ferroportin-1 (sFPN1), erythroferrone (ERFE), erythropoietin (EPO), and soluble transferrin receptor (sTfR). Results: With a median follow-up of 2.2 years, high levels of ferritin and low levels of sHJV had an adverse prognostic impact on OS and EFS in children after HCT. If these patients were combined with those with AL after intensive chemotherapy, the results were confirmed for OS and EFS both for ferritin and sHJV. Conclusions: Among the 12 analyzed serum parameters of iron metabolism, increased levels of ferritin and decreased levels of sHJV had an adverse prognostic impact on survival in children after HCT. More data are needed to clarify the relationship between ferritin, sHJV, and mortality of AL children after intensive chemotherapy, and more extensive prospective studies are required to prove sHJV predictivity. Full article

Intense physical activity contributes to an increased demand for red blood cells, which transport oxygen to working muscles. The purpose of this study was to assess the concentration of erythroferrone (ERFE), the novel marker of erythroid activity in athletes, during the beginning of their training season. The study group consisted of 39 athletes aged 23.24 ± 3.77 years. The study was carried out during the athletes’ preparatory period of the training cycle. The control group consisted of 34 healthy men aged 22.33 ± 2.77 years. The erythropoietic activity was evaluated by determining athletes’ concentrations of erythropoietin (EPO) and erythroferrone (ERFE). The level of physical activity was assessed using the International Physical Activity Questionnaire (IPAQ). In the athletes’ group, we observed higher concentrations of EPO (Me = 12.65 mIU/mL) and ERFE (40.00 pg/mL) compared to the control group (EPO: Me = 5.74 mIU/ml, p = 0.001; ERFE: Me = 25.50 pg/mL, p = 0.0034). The average intensity of physical exercise significantly differentiated the participants as far as EPO and ERFE concentrations. These results suggest that intense physical activity, at least at the beginning of the training season, may stimulate EPO production, which increases ERFE release. This seems to be an adaptative mechanism that provides adequate iron for enhanced erythropoiesis. Full article

Objective: The aim of this study was to evaluate non-transferrin-bound iron (NTBI) and labile plasma iron (LPI) levels and other parameters of iron metabolism in children undergoing therapy for acute leukemia or after hematopoietic cell transplantation (HCT), in the context of iron overload. Patients: A total number of 85 children were prospectively included into four groups: controls, acute leukemia de novo, acute leukemia after intensive treatment, and after HCT. Methods: The following iron metabolism parameters were analyzed: (1) parameters measuring functional and storage iron pools: NTBI, LPI, iron, transferrin, total iron-binding capacity, ferritin, ferritin heavy and light chains; (2) proteins regulating iron absorption and its release from tissue stores: hepcidin, soluble hemojuvelin, soluble ferroportin-1; (3) proteins regulating the erythropoietic activity of bone marrow: erythroferrone, erythropoietin, soluble transferrin receptor. Results: Intensive treatment of leukemia in children was associated with the presence of serum NTBI and LPI, which was the highest in the HCT group followed by the acute leukemia after treatment and de novo groups. In patients after HCT, the most significant changes were found in NTBI, LPI, iron, ferritin, hepcidin, and ferroportin-1 levels. Conclusions: The occurrence of NTBI and LPI in the circulation and the intensification of disturbances in iron metabolism were associated with the intensity of the anti-leukemic treatment. Full article

Objectives: Symptomatic hemorrhagic transformation (sHT) is a life-threatening complication of acute ischemic stroke (AIS). The early identification of the patients at increased risk of sHT can have clinically relevant implications. The aim of this study was to explore the validity and accuracy of the neutrophil-to-lymphocyte ratio (NLR) in predicting sHT in patients with AIS undergoing revascularization. Methods: Consecutive patients hospitalized for AIS who underwent intravenous thrombolysis, mechanical thrombectomy or both were identified. The NLR values were estimated at admission. The study endpoint was the occurrence of sHT within 24 h from stroke treatment. Results: Fifty-one patients with AIS were included, with a median age of 67 (interquartile range, 55–78) years. sHT occurred in 10 (19.6%) patients. Patients who developed sHT had higher NLR at admission. NLR was an independent predictor of sHT and showed good discriminatory power (area under the curve 0.81). In a multivariable analysis, NLR and systolic blood pressure were independently associated with sHT. Conclusions: NLR at admission can accurately predict sHT in patients with AIS undergoing revascularization. Full article

Infection with severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) is a rapidly spreading and devastating global pandemic. Many researchers are attempting to clarify the mechanisms of infection and to develop a drug or vaccine against the virus, but there are still no proven effective treatments. The present article reviews the common presenting hematological manifestations of coronavirus disease 2019 (COVID–19). Elucidating the changes in hematological parameters in SARS–CoV–2 infected patients could help to understand the pathophysiology of the disease and may provide early clues to diagnosis. Several studies have shown that hematological parameters are markers of disease severity and suggest that they mediate disease progression. Full article

Background and Objectives: Ischaemic stroke (IS) is the leading cause of death and disability worldwide. All stages of cerebral ischaemia, but especially acute phase, are associated with inflammatory response. Recent studies showed that neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR) may be used to assess inflammation in IS. To test whether there is a relationship between these parameters and type of stroke treatment, we analysed NLR and LMR in IS patients treated with three different modalities. Materials and Methods: The study included 58 adults with acute IS. A total of 28 patients received intravenous thrombolysis. In another 10 patients, the thrombolytic therapy was followed by thrombectomy and 20 patients did not undergo causal treatment. Blood samples were obtained within 24 h of the stroke diagnosis to calculate NLR and LMR. Next, NLR and LMR of the study subgroups were compared. Results: Our study revealed that NLR was significantly higher in patients treated with thrombectomy following thrombolysis, compared to no causal treatment. Statistical analysis demonstrated that patients with high National Institutes of Health Stroke Scale (NIHSS) scores presented higher NLR than in those with low NIHSS scores. Additionally, patients with high-sensitivity C-reactive protein (hs-CRP) ≥ 3 mg/L presented with significantly higher NLR and significantly lower LMR than the group of patients with lower hs-CRP (<3 mg/L). Conclusions: The main finding of this pilot study was that NLR in IS patients treated using thrombectomy following thrombolysis was markedly higher than that in other treatment groups, which was associated with increased severity of the disease in these patients. Therefore, patients with higher NLR may be expected to have more severe stroke. The link between stroke severity and NLR deserves further study. Full article

Background and Objectives: Top-level sports performance places heavy physical and psychological demands on elite-level athletes, which can be a source of increased levels of stress. Therefore, high-level volleyball players may present altered cardiovascular and endocrinological stress response during stressful events. Although many previous studies have examined the response to stress on athletes, most of them regarded only males, while the impact of the female menstrual cycle has rarely been taken into account. We aimed to study psychophysiological response to anticipatory stressor through analysis of heart rate, self-reported anxiety level, and salivary cortisol in healthy young female athletes by minimalizing the effect of confounders. Materials and Methods: A total of 55 females (25 members of the best league for female volleyball players in Poland and 30 sedentary-lifestyle control subjects) in the follicular phase of their menstrual cycle were exposed to mental arithmetic tasks as an experimental imitation of the stressor. Volleyball players were significantly taller than sedentary individuals (177.1 ± 3.4 cm vs. 173.3 ± 3.4 cm, respectively, p = 0.034), but did not differ in weight (73.6 ± 5.2 kg vs. 70 ± 4.23 kg, respectively, p = 0.081), body mass index (BMI) (23.5 ± 1.13 vs. 24.1 ± 1.45, respectively, p = 0.060), and age (22 ± 1.11 vs. 23 ± 1.14 years, respectively, p = 0.2). Their stress responses were assessed through self-reported anxiety levels and physiological measurements of salivary cortisol concentrations and heart rate (HR). Results: For HR, significant effects of time (F_(2,120) = 21.34, p < 0.001, η² = 0.26) were found, but not for training status (F_(1,60) = 2.69, p = 0.106, η² = 0.04). For cortisol levels, the analysis showed the main effects of time (F_(3,180) = 11.73, p < 0.001, η² = 0.16) and training status (F_(1,60) = 4.69, p = 0.034, η² = 0.07) and a significant interaction between training status and time (F_(3,180) = 3.07, p = 0.029, η² = 0.05). Post-hoc analyses showed higher cortisol concentrations among volleyball players following the math task (all p < 0.001), as well as higher cortisol concentrations in S2, S3, and S4 compared to S1 in volleyball players (all p < 0.001). We observed also a significant increase in state anxiety in both groups (all p < 0.001), but no differences in state anxiety levels between groups. Conclusion: Female volleyball players may not differ in subjective graduation of stressors; however, exposure to training-based stressors seems to promote cortisol response to the anticipated stressor. Full article

Introduction: The natural anticoagulant—activated protein C system plays an important role in the pathogenesis of idiopathic pulmonary fibrosis. The purpose of this study was to evaluate the concentration of protein C (PC), protein S (PS), thrombomodulin (TM), selectin E (sSelE), and thrombin–antithrombin complex (TAT) in patients with idiopathic pulmonary fibrosis (IPF). Material and methods: Study grup consisted of 11 patients aged 51.5 ± 8.62 years with idiopathic pulmonary fibrosis and 20 healthy adults as control. Concentration of PC, PS TM, sSelE and TAT in plasma with ELISA method was assessed. Results: We observed significantly lower plasma concentration of PC (98.24 ± 16.17% vs. 130.59 ± 19.03%), PS (71.31 ± ± 12.95% vs. 93.47 ± 18.63%), TM (2.67 ± 0.40 ng/ml vs. 3.99 ± 1.16 ng/ml) and significantly higher level of TAT complex (Me = 4.00 mg/ml vs. 2.20 mg/ml) and sSelE (Me = 36.40 ng/ml vs. 22.84 ng/ml) in patients with idiopathic pulmonary fibrosis as compared to controls. Conclusions: In presented pilot study we observed decreased activity of protein C system and increased thrombin generation in peripheral blood of patients with idiopathic pulmonary fibrosis. Full article