Sylwia Michalak - Academia.edu (original) (raw)

Papers by Sylwia Michalak

Family Medicine & Primary Care Review, Apr 11, 2016

A-przygotowanie projektu badania, B-zbieranie danych, C-analiza statystyczna, D-interpretacja dan... more A-przygotowanie projektu badania, B-zbieranie danych, C-analiza statystyczna, D-interpretacja danych, E-przygotowanie maszynopisu, F-opracowanie piśmiennictwa, G-pozyskanie funduszy Przewlekła białaczka szpikowa należy do nowotworowych schorzeń hematologicznych, których rokowanie, w odniesieniu do całkowitego przeżycia, znacząco poprawiło się w ostatnich latach. Ma to związek z wprowadzeniem inhibitorów kinaz tyrozynowych (tyrosine kinase inhibitors-TKI), doustnych leków działających na produkt zmutowanego genu BCR-ABL oraz poprawą wyników przeszczepiania komórek krwiotwórczych. Konieczność wieloletniego przyjmowania TKI wiąże się z możliwością występowania objawów ubocznych i interakcji lekowych, o których musi wiedzieć lekarz rodzinny. Inhibitory kinaz tyrozynowych, podobnie jak szereg leków stosowanych w podstawowej opiece zdrowotnej, metabolizowane są przez enzymy cytochromu P-450 oraz mają wpływ na białka transportu komórkowego. Powoduje to wzajemne oddziaływanie leków na siebie, co wpływa na efekty leczenia białaczki i chorób współistniejących. Przez prowadzenie profilaktyki zdrowotnej, edukacji, szybkie rozpoznawanie i niekiedy leczenie objawów niepożądanych, lekarz pierwszego kontaktu może mieć istotny wpływ na poprawę przestrzegania zaleceń onkologicznych i skuteczność terapii białaczki. Znaczenie ma również rozwijanie współpracy między hematologiem a lekarzem rodzinnym. W pracy przedstawiono podstawowe zasady leczenia przewlekłej białaczki szpikowej oraz charakterystykę TKI w odniesieniu do działań niepożądanych oraz interakcji lekowych, ze zwróceniem uwagi na leki najczęściej stosowane w podstawowej opiece zdrowotnej. Istotnym celem pracy jest wywołanie dyskusji w środowisku lekarskim na temat roli lekarza rodzinnego w leczeniu przewlekłej białaczki szpikowej, a także innych schorzeń nowotworowych. Słowa kluczowe: przewlekła białaczka szpikowa, inhibitory kinazy tyrozynowej, interakcje lekowe. Prognosis and overall survival of patients with chronic myeloid leukemia (CML) have improved considerably in recent years due to the introduction of tyrosine kinase inhibitors (TKI), oral medicines inhibiting the mutant forms of BCR-ABL, and improved results of allogeneic stem cell transplantations. The necessity of long-term drug therapy is connected with a possibility of adverse effects and drug interactions each family doctor should be aware of. The tyrosine kinase inhibitors, alike numerous drugs used in basic health care, are metabolized by cytochrome P450 enzymes and influence the cellular transport proteins. Consequently, this leads to drug interactions that affect both leukemia and its concomitant diseases' treatment results. Due to health prevention and education, rapid identification and treatment of side effects, the primary care physician can greatly influence better compliance with oncologic recommendations and effectiveness of leukemia therapy. Furthermore, equally important is developing cooperation between the hematologist and the primary care physician. Current treatment recommendations for CML, as well as TKI characteristic with respect to side effects and drug interactions, are discussed in the paper. The important purpose of this paper is to provoke a discussion within medical community on the importance of the primary care physician in chronic myeloid leukemia treatment or other malignancies.

Family Medicine & Primary Care Review, 2016

Przewlekła białaczka szpikowa należy do nowotworowych schorzeń hematologicznych, których rokowani... more Przewlekła białaczka szpikowa należy do nowotworowych schorzeń hematologicznych, których rokowanie, w odniesieniu do całkowitego przeżycia, znacząco poprawiło się w ostatnich latach. Ma to związek z wprowadzeniem inhibitorów kinaz tyrozynowych (tyrosine kinase inhibitors – TKI), doustnych leków działających na produkt zmutowanego genu BCR-ABL oraz poprawą wyników przeszczepiania komórek krwiotwórczych. Konieczność wieloletniego przyjmowania TKI wiąże się z możliwością występowania objawów ubocznych i interakcji lekowych, o których musi wiedzieć lekarz rodzinny. Inhibitory kinaz tyrozynowych, podobnie jak szereg leków stosowanych w podstawowej opiece zdrowotnej, metabolizowane są przez enzymy cytochromu P-450 oraz mają wpływ na białka transportu komórkowego. Powoduje to wzajemne oddziaływanie leków na siebie, co wpływa na efekty leczenia białaczki i chorób współistniejących. Przez prowadzenie profilaktyki zdrowotnej, edukacji, szybkie rozpoznawanie i niekiedy leczenie objawów niepożą...

Psychology, Health & Medicine

The objective of this paper was to assess the impact of the COVID-19 pandemic on the mental healt... more The objective of this paper was to assess the impact of the COVID-19 pandemic on the mental health of Poles and the availability of psychiatric and psychological support during the pandemic. A prospective, cross-sectional web-based survey design was adopted. It was carried out on a sample of 1080 Polish citizens above 18 years old. The majority of Poles (70%) experienced symptoms of mental disorders during the COVID-19 pandemic. Sleep disturbance (63.79%), anxiety (48.79%), low mood for most of the day (44.63%), sadness, tearfulness (41.29%), and concentration disorders (35.93%) were the mental disorder symptoms reported most often by the survey subjects. To reduce the potential acute and long-lasting effects of the COVID-19 pandemic on mental health, decision-makers of the Polish health system should implement stepped multilevel and multi-target psychological support services.

Encyclopedia of Gerontology and Population Aging, 2019

Idiopathic autoimmune hemolytic anemia; Immune hemolytic anemia; Immune-mediated hemolytic anemia... more Idiopathic autoimmune hemolytic anemia; Immune hemolytic anemia; Immune-mediated hemolytic anemia Definition Hemolytic anemias form a group of diseases of various etiologies, characterized by increased breakdown of red blood cells and shortening of their survival time. One of the forms of hemolytic anemia is autoimmune hemolytic anemia (AIHA), which is confirmed by erythrocyte destruction with the presence of autoantibodies and/or complement and usually a positive direct antiglobulin test (DAT). AIHA may be in primary or secondary form and can be divided into serological types: warm AIHA (wAIHA), cold agglutinin disease (CAD), mixed AIHA, and paroxysmal cold hemoglobinuria (PCH) (Berentsen and Sundic 2015; Barcellini 2015; Hill et al. 2017). Overview Anemia is a common symptom in older people; it increases with age and has many causes. The most common types of anemia in older people are deficiency, chronic, and unexplained anemias (Michalak et al. 2018). AIHA is a rare cause of anemia, and it is estimated that its prevalence is 17 per 100,000 people (Eaton et al. 2007). Warm AIHA is more common than other types of AIHA, with an incidence of 1 per 100,000, with about 80% of AIHA patients having warm-type antibodies (Packman 2008). The incidence rate of primary CAD is one person per million per year, with the average age of patients with CAD being 67 years (Berentsen and Sundic 2015). AIHA can occur at any age, but the risk increases with age. Based on data from 865 AIHA patients, collected over a period of approximately 20 years and published in 1981, a systematic significant increase in the incidence of all AIHA subtypes with age was observed. AIHA incidence rates were 5 times higher in patients over 70 years of age compared to patients aged 41-50 and amounted to approximately 2 per 100,000 people with wAIHA while about 1 person per 100,000 people with CAD (Sokol et al. 1981). There are different types of AIHA: wAIHA, CAD, and mixed AIHA differ in the number of specific classes of immunoglobulins (Ig), the degree of complement activation and the site, and mechanism of destruction of red blood cells. The main factor differentiating individual AIHA

Encyclopedia of Gerontology and Population Aging, 2021

Acta Poloniae Pharmaceutica - Drug Research, 2021

SARS-CoV-2, the virus that causes COVID-19, has had a major impact on human health globally;infec... more SARS-CoV-2, the virus that causes COVID-19, has had a major impact on human health globally;infecting a large number of people and resulting in increased mortality. The WHO has received many reports of SARS-CoV-2 mutations and variants. The best-known variants are the British, South African, and Brazilian variants, which differ in the genetic record but share the N501Y mutation, which exists in the receptor-binding domain, and is critical for binding to the human ACE2 receptor (angiotensin-converting enzyme 2). So far, mRNA (Pfizer, Moderna) and vector (Astra Zeneca, Johnson & Johnson) vaccines have been used against the SARS-CoV-2 virus. Others are undergoing diagnostic tests. However, further research is needed to show how the respective vaccines deal with the identified mutations and the whole range of SARS-CoV-2 variants. A systematic review including the current evidence related to different variants of SARS-CoV-2 and COVID-19 vaccines was conducted through a systemic search ut...

Journal of Diabetes Research, 2021

Diabetes mellitus (DM) and also anemia are common in the elderly and have a negative impact on th... more Diabetes mellitus (DM) and also anemia are common in the elderly and have a negative impact on the clinical outcomes of patients. The coexistence of anemia and DM seems to be insufficiently recognized; therefore, the aim of our study is to analyze the incidence and clinical consequences of this coexistence, including mortality, in the population of people aged ≥60. A retrospective study was conducted on 981 primary care clinic patients aged ≥60 during 2013-2014. The prevalence of coexistence of DM and anemia (defined in accordance with WHO) and data on the incidence of comorbidities, hospitalization, medical procedures, and all-cause mortality were analyzed. In the study population, 25% had DM, while 5.4% had both DM and anemia. Peripheral artery disease (PAD) was found in 48 patients (4.89%) of the entire study population, more often in men (p<0.001). Diabetic patients with anemia compared to nonanemic diabetics had more comorbidities (median 4 (4, 5) vs. 3 (2–4);p<0.001)—PAD...

Immunity & Ageing, 2020

Autoimmune hemolytic anemia (AIHA) is an acquired, heterogeneous group of diseases which includes... more Autoimmune hemolytic anemia (AIHA) is an acquired, heterogeneous group of diseases which includes warm AIHA, cold agglutinin disease (CAD), mixed AIHA, paroxysmal cold hemoglobinuria and atypical AIHA. Currently CAD is defined as a chronic, clonal lymphoproliferative disorder, while the presence of cold agglutinins underlying other diseases is known as cold agglutinin syndrome. AIHA is mediated by autoantibodies directed against red blood cells (RBCs) causing premature erythrocyte destruction. The pathogenesis of AIHA is complex and still not fully understood. Recent studies indicate the involvement of T and B cell dysregulation, reduced CD4+ and CD25+ Tregs, increased clonal expansions of CD8 + T cells, imbalance of Th17/Tregs and Tfh/Tfr, and impaired lymphocyte apoptosis. Changes in some RBC membrane structures, under the influence of mechanical stimuli or oxidative stress, may promote autohemolysis. The clinical presentation and treatment of AIHA are influenced by many factors, ...

Acta Haematologica Polonica, 2020

Iron deficiency anemia (IDA) treatment is done to eliminate the causes of iron deficiency, iron s... more Iron deficiency anemia (IDA) treatment is done to eliminate the causes of iron deficiency, iron supplementation, and rarely red blood cell transfusion. Divalent iron salts are the first line of oral treatment, but their use lead to frequent gastrointestinal adverse reactions. Iron is administered intravenously in the event of contraindications, intolerance, or inefficiency of oral therapy, but the parenteral route of drug delivery is not easily accepted by the patients. Intravenous preparations for single administration of a large dose of iron have a good therapy safety profile, but are more expensive than oral and are usually administered in a hospital setting. The availability of new iron compounds: sucrosomial iron, ferric citrate complexes, and ferric maltol widen the possibilities of IDA therapy and enable the better selection of iron preparations in various clinical situations. The innovative structure of sucrosomial iron leads to absorption in different ways (through endocyto...

Acta Haematologica Polonica, 2020

The incidence of anemia of chronic disease (ACD) is underestimated, increases with age, and affec... more The incidence of anemia of chronic disease (ACD) is underestimated, increases with age, and affects about 30% of the elderly. ACD treatment is currently based on the pharmacotherapy of diseases that caused anemia, erythropoiesis-stimulating agents, and parenteral administration of iron supplementation in case of iron deficiency. Increasing knowledge on the pathophysiology of ACD has resulted in the burst of research on the development of new drugs that are focused on three main areas. The first group of drugs includes substances that inhibit hepcidin transcription, namely direct and indirect bone morphogenetic protein 6 (BMP6) inhibitors and/or SMAD signaling pathway inhibitors, and drugs that regulate hepcidin transcription through STAT3 signaling pathway. The second group of drugs includes direct hepcidin inhibitors (e.g., aptamers, anticalin proteins, monoclonal antibodies) or substances that inhibit the binding of hepcidin to ferroportin. The third group of drugs improves erythr...

Postępy Mikrobiologii - Advancements of Microbiology, 2020

Severe acute respiratory syndrome coronavirus is a new infectious disease caused by a novel coron... more Severe acute respiratory syndrome coronavirus is a new infectious disease caused by a novel coronavirus (SARS-CoV-2). In February 2020 WHO renamed the disease to coronavirus disease 2019 (COVID-19). Coronaviruses belong to the family of Coronaviridae, order Nidovirales. Scientists have visualized the appearance of the SARS-CoV-2 using microscopic techniques, which has a crown-like shape and contains four structural proteins – S, E, M and N. ACE2 (angiotensin converting enzyme 2) is a receptor to which SARS-CoV-2 virus particles bind. The primary test to diagnose infection is the RT-PCR (Real time RT-PCR). Research is underway to identify vaccine against SARS-CoV-2 and therapeutic treatments for COVID-19. 1. Introduction. 2. Epidemiology and pathogenesis of the disease. 3. Molecular structure, division and origin of coronaviruses. 4. Coronavirus binding receptors. 5. Ways of transferring infection. 6. Symptoms and course of infection. 7. Preventive recommendations. 8. Characteristics...

Medical Science Monitor, 2020

Background: Biomarkers predicting the efficacy of treatment for locally limited prostate cancer a... more Background: Biomarkers predicting the efficacy of treatment for locally limited prostate cancer are greatly needed. This knowledge could improve the classification of patients for different methods of treatment and enable better recognition of groups with higher risk of biological recurrence. We prospectively assessed serial blood levels of apoptotic biomarkers and correlated them with response to treatment and clinical factors. Material/Methods: Blood was collected from 25 patients with prostate cancer before and after surgery, 16 healthy volunteers with benign prostatic hyperplasia (BPH), and 14 patients with metastasized disease. Immunoenzymatic methods were used to determine circulating apoptotic and inflammatory mediators, including tumor necrosis factor a (TNF-a), type I receptor (TNFRI), and type II receptor (TNFRII); FAS ligand (FasL); TNF-related apoptosis-inducing ligand (TRIAL); caspase 8 (Cas8); caspase 9 (Cas9); DNA methylation (metDNA); P-selectin; and high-sensitivity C-reactive protein. The total circulating fragments of cell-free DNA (cfDNA) were measured directly in serum. Results: Peripheral serum prostate-specific antigen increased rapidly together with cfDNA. A negative correlation was noted between tumor volume and TNFRI and TNFRII. Postsurgery P-selectin level was decreased, and metD-NA and TNFRII levels were increased. Three comparisons were made between patient groups: surgical vs. BPH; surgical vs. palliative; and palliative vs. BPH. TNFRI, TNFRII, metDNA, P-selectin, Cas8, and FasL were shown to have significant roles. Conclusions: The study indicated significant roles for cfDNA, both TNF receptors, metDNA, and P-selectin as serum biomarkers in patients with prostate cancer.

Acta Poloniae Pharmaceutica - Drug Research, 2019

At present, the only active substance of Gentian Violet (GV) is methylrosaniline ñ a triphenylmet... more At present, the only active substance of Gentian Violet (GV) is methylrosaniline ñ a triphenylmethane dye of which amino group contains 2 methyl groups. GV can be used to treat uncomplicated bacterial and/or yeast infections, support antibiotic therapy of more severe infections, but also to protect medical equipment against colonization by microorganisms. In the light of recent studies, there are many new possibilities for GV application. It has been shown to be effective in the treatment of viral infections, some chronic skin diseases and oncology. GV can induce apoptosis of tumor cells among others by elevating caspase 8, inhibiting NADPH oxidases, decreasing mitochondrial thioredoxin 2 or inhibiting STAT3/SOX2 axis. Preclinical and in vitro studies have also demonstrated GV efficacy in the treatment of breast cancer, melanoma tumors and cutaneous T-cell lymphoma. There is no unambiguous evidence indicating the toxicity of GV, whereas its safety has been proven by its long history of use, its inclusion in numerous guidelines and its legal trade and distribution with no specific approval requested in many countries around the world. The article gathers the available knowledge about GV and its potential use in the future.

Archives of Medical Science, 2019

Introduction: We aimed to analyze the prevalence of unexplained anemia (UA) and assess its charac... more Introduction: We aimed to analyze the prevalence of unexplained anemia (UA) and assess its characteristics, potential causes and impact on survival in an elderly population. Material and methods: Medical files of 981 patients aged ≥ 60 years consulted in one primary medical clinic in Poland in 2013-2014 were retrospectively analyzed. Anemia, defined according to WHO criteria, diagnosed during either hospitalization or outpatient treatment, from the age of 60, was included. Unexplained anemia was diagnosed if, based on available clinical data and laboratory tests and other assessments in medical records, none of the well-known types of anemia were identified. Results: Of 981 patients with anemia, UA was found in 48 (28.4%) patients (4.9% of those studied) and incidence increased with age (≥ 80 years, 12.3%). In 81.3% no full hematological diagnostics were performed. Patients with UA, as with those with defined anemia, when compared to the group without anemia were older, had more co-morbidities, were more frequently hospitalized, more frequently had dementia syndrome and obtained lower Barthel scores (p < 0.0001). In the groups of patients with UA and defined anemia, there were more deaths than in those without anemia (10% vs. 13% vs. 2%, p < 0.0001) with significant differences in survival rates observed during 3-year follow-up. Conclusions: The increasing incidence with age of UA in the elderly population, insufficient diagnosis and the higher mortality of patients with UA in comparison to the group without anemia indicate the need to develop recommendations for its management by primary care physicians.

Annals of Hematology, 2018

Anemia represents a common condition among the elderly; however, its prevalence and causes are no... more Anemia represents a common condition among the elderly; however, its prevalence and causes are not well known. This retrospective analysis was performed on 981 patients aged ≥ 60 in Poland over 2013-2014. The prevalence of anemia was 17.2% and increased with age. The predominant causes of anemia were the following: anemia of chronic disease (33.1%), unexplained anemia (28.4%), deficiency anemia (22.5%, including iron deficiency 13%), and chemo-/radiotherapy-induced anemia (8.9%). In the multivariate logistic regression model, factors increasing the risk of anemia were the following: age ≥

Psychiatria Polska

Anemia i depresja są powszechne u osób w podeszłym wieku i stanowią istotny problem medyczny, spo... more Anemia i depresja są powszechne u osób w podeszłym wieku i stanowią istotny problem medyczny, społeczny i ekonomiczny świata. Obydwa zaburzenia wiążą się z niską jakością życia, wielochorobowością, zwiększonym ryzykiem śmierci. Równoczesne występowanie anemii i depresji zostało potwierdzone w badaniach, ale mechanizmy i konsekwencje kliniczne tej koegzystencji nie zostały dotąd w pełni wyjaśnione. Istnieje szereg powiązań pomiędzy anemią a depresją takich jak wspólne czynniki etiologiczne, niski status socjoekonomiczny pacjentów, niskie wykształcenie oraz mniejsza aktywność fizyczna. W obydwu zaburzeniach stwierdza się te same patologiczne zmiany zależne od wieku (zwłaszcza obecność stanu zapalnego i stresu oksydacyjnego, zmiany degeneracyjne tkanek i narządów), niedobory żelaza czy witamin (B12, kwasu foliowego), zaburzenia hormonalne (zwłaszcza choroby tarczycy, niedobory hormonów płciowych). Zarówno anemia jak i depresja u osób starszych są w niewystarczającym stopniu rozpoznawan...

Psychiatria Polska

Anemia i depresja są powszechne u osób w podeszłym wieku i stanowią istotny problem medyczny, spo... more Anemia i depresja są powszechne u osób w podeszłym wieku i stanowią istotny problem medyczny, społeczny i ekonomiczny świata. Obydwa zaburzenia wiążą się z niską jakością życia, wielochorobowością, zwiększonym ryzykiem śmierci. Równoczesne występowanie anemii i depresji zostało potwierdzone w badaniach, ale mechanizmy i konsekwencje kliniczne tej koegzystencji nie zostały dotąd w pełni wyjaśnione. Istnieje szereg powiązań pomiędzy anemią a depresją takich jak wspólne czynniki etiologiczne, niski status socjoekonomiczny pacjentów, niskie wykształcenie oraz mniejsza aktywność fizyczna. W obydwu zaburzeniach stwierdza się te same patologiczne zmiany zależne od wieku (zwłaszcza obecność stanu zapalnego i stresu oksydacyjnego, zmiany degeneracyjne tkanek i narządów), niedobory żelaza czy witamin (B12, kwasu foliowego), zaburzenia hormonalne (zwłaszcza choroby tarczycy, niedobory hormonów płciowych). Zarówno anemia jak i depresja u osób starszych są w niewystarczającym stopniu rozpoznawan...

Family Medicine & Primary Care Review, Apr 11, 2016

A-przygotowanie projektu badania, B-zbieranie danych, C-analiza statystyczna, D-interpretacja dan... more A-przygotowanie projektu badania, B-zbieranie danych, C-analiza statystyczna, D-interpretacja danych, E-przygotowanie maszynopisu, F-opracowanie piśmiennictwa, G-pozyskanie funduszy Przewlekła białaczka szpikowa należy do nowotworowych schorzeń hematologicznych, których rokowanie, w odniesieniu do całkowitego przeżycia, znacząco poprawiło się w ostatnich latach. Ma to związek z wprowadzeniem inhibitorów kinaz tyrozynowych (tyrosine kinase inhibitors-TKI), doustnych leków działających na produkt zmutowanego genu BCR-ABL oraz poprawą wyników przeszczepiania komórek krwiotwórczych. Konieczność wieloletniego przyjmowania TKI wiąże się z możliwością występowania objawów ubocznych i interakcji lekowych, o których musi wiedzieć lekarz rodzinny. Inhibitory kinaz tyrozynowych, podobnie jak szereg leków stosowanych w podstawowej opiece zdrowotnej, metabolizowane są przez enzymy cytochromu P-450 oraz mają wpływ na białka transportu komórkowego. Powoduje to wzajemne oddziaływanie leków na siebie, co wpływa na efekty leczenia białaczki i chorób współistniejących. Przez prowadzenie profilaktyki zdrowotnej, edukacji, szybkie rozpoznawanie i niekiedy leczenie objawów niepożądanych, lekarz pierwszego kontaktu może mieć istotny wpływ na poprawę przestrzegania zaleceń onkologicznych i skuteczność terapii białaczki. Znaczenie ma również rozwijanie współpracy między hematologiem a lekarzem rodzinnym. W pracy przedstawiono podstawowe zasady leczenia przewlekłej białaczki szpikowej oraz charakterystykę TKI w odniesieniu do działań niepożądanych oraz interakcji lekowych, ze zwróceniem uwagi na leki najczęściej stosowane w podstawowej opiece zdrowotnej. Istotnym celem pracy jest wywołanie dyskusji w środowisku lekarskim na temat roli lekarza rodzinnego w leczeniu przewlekłej białaczki szpikowej, a także innych schorzeń nowotworowych. Słowa kluczowe: przewlekła białaczka szpikowa, inhibitory kinazy tyrozynowej, interakcje lekowe. Prognosis and overall survival of patients with chronic myeloid leukemia (CML) have improved considerably in recent years due to the introduction of tyrosine kinase inhibitors (TKI), oral medicines inhibiting the mutant forms of BCR-ABL, and improved results of allogeneic stem cell transplantations. The necessity of long-term drug therapy is connected with a possibility of adverse effects and drug interactions each family doctor should be aware of. The tyrosine kinase inhibitors, alike numerous drugs used in basic health care, are metabolized by cytochrome P450 enzymes and influence the cellular transport proteins. Consequently, this leads to drug interactions that affect both leukemia and its concomitant diseases' treatment results. Due to health prevention and education, rapid identification and treatment of side effects, the primary care physician can greatly influence better compliance with oncologic recommendations and effectiveness of leukemia therapy. Furthermore, equally important is developing cooperation between the hematologist and the primary care physician. Current treatment recommendations for CML, as well as TKI characteristic with respect to side effects and drug interactions, are discussed in the paper. The important purpose of this paper is to provoke a discussion within medical community on the importance of the primary care physician in chronic myeloid leukemia treatment or other malignancies.

Family Medicine & Primary Care Review, 2016

Przewlekła białaczka szpikowa należy do nowotworowych schorzeń hematologicznych, których rokowani... more Przewlekła białaczka szpikowa należy do nowotworowych schorzeń hematologicznych, których rokowanie, w odniesieniu do całkowitego przeżycia, znacząco poprawiło się w ostatnich latach. Ma to związek z wprowadzeniem inhibitorów kinaz tyrozynowych (tyrosine kinase inhibitors – TKI), doustnych leków działających na produkt zmutowanego genu BCR-ABL oraz poprawą wyników przeszczepiania komórek krwiotwórczych. Konieczność wieloletniego przyjmowania TKI wiąże się z możliwością występowania objawów ubocznych i interakcji lekowych, o których musi wiedzieć lekarz rodzinny. Inhibitory kinaz tyrozynowych, podobnie jak szereg leków stosowanych w podstawowej opiece zdrowotnej, metabolizowane są przez enzymy cytochromu P-450 oraz mają wpływ na białka transportu komórkowego. Powoduje to wzajemne oddziaływanie leków na siebie, co wpływa na efekty leczenia białaczki i chorób współistniejących. Przez prowadzenie profilaktyki zdrowotnej, edukacji, szybkie rozpoznawanie i niekiedy leczenie objawów niepożą...

Psychology, Health & Medicine

The objective of this paper was to assess the impact of the COVID-19 pandemic on the mental healt... more The objective of this paper was to assess the impact of the COVID-19 pandemic on the mental health of Poles and the availability of psychiatric and psychological support during the pandemic. A prospective, cross-sectional web-based survey design was adopted. It was carried out on a sample of 1080 Polish citizens above 18 years old. The majority of Poles (70%) experienced symptoms of mental disorders during the COVID-19 pandemic. Sleep disturbance (63.79%), anxiety (48.79%), low mood for most of the day (44.63%), sadness, tearfulness (41.29%), and concentration disorders (35.93%) were the mental disorder symptoms reported most often by the survey subjects. To reduce the potential acute and long-lasting effects of the COVID-19 pandemic on mental health, decision-makers of the Polish health system should implement stepped multilevel and multi-target psychological support services.

Encyclopedia of Gerontology and Population Aging, 2019

Idiopathic autoimmune hemolytic anemia; Immune hemolytic anemia; Immune-mediated hemolytic anemia... more Idiopathic autoimmune hemolytic anemia; Immune hemolytic anemia; Immune-mediated hemolytic anemia Definition Hemolytic anemias form a group of diseases of various etiologies, characterized by increased breakdown of red blood cells and shortening of their survival time. One of the forms of hemolytic anemia is autoimmune hemolytic anemia (AIHA), which is confirmed by erythrocyte destruction with the presence of autoantibodies and/or complement and usually a positive direct antiglobulin test (DAT). AIHA may be in primary or secondary form and can be divided into serological types: warm AIHA (wAIHA), cold agglutinin disease (CAD), mixed AIHA, and paroxysmal cold hemoglobinuria (PCH) (Berentsen and Sundic 2015; Barcellini 2015; Hill et al. 2017). Overview Anemia is a common symptom in older people; it increases with age and has many causes. The most common types of anemia in older people are deficiency, chronic, and unexplained anemias (Michalak et al. 2018). AIHA is a rare cause of anemia, and it is estimated that its prevalence is 17 per 100,000 people (Eaton et al. 2007). Warm AIHA is more common than other types of AIHA, with an incidence of 1 per 100,000, with about 80% of AIHA patients having warm-type antibodies (Packman 2008). The incidence rate of primary CAD is one person per million per year, with the average age of patients with CAD being 67 years (Berentsen and Sundic 2015). AIHA can occur at any age, but the risk increases with age. Based on data from 865 AIHA patients, collected over a period of approximately 20 years and published in 1981, a systematic significant increase in the incidence of all AIHA subtypes with age was observed. AIHA incidence rates were 5 times higher in patients over 70 years of age compared to patients aged 41-50 and amounted to approximately 2 per 100,000 people with wAIHA while about 1 person per 100,000 people with CAD (Sokol et al. 1981). There are different types of AIHA: wAIHA, CAD, and mixed AIHA differ in the number of specific classes of immunoglobulins (Ig), the degree of complement activation and the site, and mechanism of destruction of red blood cells. The main factor differentiating individual AIHA

Encyclopedia of Gerontology and Population Aging, 2021

Acta Poloniae Pharmaceutica - Drug Research, 2021

SARS-CoV-2, the virus that causes COVID-19, has had a major impact on human health globally;infec... more SARS-CoV-2, the virus that causes COVID-19, has had a major impact on human health globally;infecting a large number of people and resulting in increased mortality. The WHO has received many reports of SARS-CoV-2 mutations and variants. The best-known variants are the British, South African, and Brazilian variants, which differ in the genetic record but share the N501Y mutation, which exists in the receptor-binding domain, and is critical for binding to the human ACE2 receptor (angiotensin-converting enzyme 2). So far, mRNA (Pfizer, Moderna) and vector (Astra Zeneca, Johnson & Johnson) vaccines have been used against the SARS-CoV-2 virus. Others are undergoing diagnostic tests. However, further research is needed to show how the respective vaccines deal with the identified mutations and the whole range of SARS-CoV-2 variants. A systematic review including the current evidence related to different variants of SARS-CoV-2 and COVID-19 vaccines was conducted through a systemic search ut...

Journal of Diabetes Research, 2021

Diabetes mellitus (DM) and also anemia are common in the elderly and have a negative impact on th... more Diabetes mellitus (DM) and also anemia are common in the elderly and have a negative impact on the clinical outcomes of patients. The coexistence of anemia and DM seems to be insufficiently recognized; therefore, the aim of our study is to analyze the incidence and clinical consequences of this coexistence, including mortality, in the population of people aged ≥60. A retrospective study was conducted on 981 primary care clinic patients aged ≥60 during 2013-2014. The prevalence of coexistence of DM and anemia (defined in accordance with WHO) and data on the incidence of comorbidities, hospitalization, medical procedures, and all-cause mortality were analyzed. In the study population, 25% had DM, while 5.4% had both DM and anemia. Peripheral artery disease (PAD) was found in 48 patients (4.89%) of the entire study population, more often in men (p<0.001). Diabetic patients with anemia compared to nonanemic diabetics had more comorbidities (median 4 (4, 5) vs. 3 (2–4);p<0.001)—PAD...

Immunity & Ageing, 2020

Autoimmune hemolytic anemia (AIHA) is an acquired, heterogeneous group of diseases which includes... more Autoimmune hemolytic anemia (AIHA) is an acquired, heterogeneous group of diseases which includes warm AIHA, cold agglutinin disease (CAD), mixed AIHA, paroxysmal cold hemoglobinuria and atypical AIHA. Currently CAD is defined as a chronic, clonal lymphoproliferative disorder, while the presence of cold agglutinins underlying other diseases is known as cold agglutinin syndrome. AIHA is mediated by autoantibodies directed against red blood cells (RBCs) causing premature erythrocyte destruction. The pathogenesis of AIHA is complex and still not fully understood. Recent studies indicate the involvement of T and B cell dysregulation, reduced CD4+ and CD25+ Tregs, increased clonal expansions of CD8 + T cells, imbalance of Th17/Tregs and Tfh/Tfr, and impaired lymphocyte apoptosis. Changes in some RBC membrane structures, under the influence of mechanical stimuli or oxidative stress, may promote autohemolysis. The clinical presentation and treatment of AIHA are influenced by many factors, ...

Acta Haematologica Polonica, 2020

Iron deficiency anemia (IDA) treatment is done to eliminate the causes of iron deficiency, iron s... more Iron deficiency anemia (IDA) treatment is done to eliminate the causes of iron deficiency, iron supplementation, and rarely red blood cell transfusion. Divalent iron salts are the first line of oral treatment, but their use lead to frequent gastrointestinal adverse reactions. Iron is administered intravenously in the event of contraindications, intolerance, or inefficiency of oral therapy, but the parenteral route of drug delivery is not easily accepted by the patients. Intravenous preparations for single administration of a large dose of iron have a good therapy safety profile, but are more expensive than oral and are usually administered in a hospital setting. The availability of new iron compounds: sucrosomial iron, ferric citrate complexes, and ferric maltol widen the possibilities of IDA therapy and enable the better selection of iron preparations in various clinical situations. The innovative structure of sucrosomial iron leads to absorption in different ways (through endocyto...

Acta Haematologica Polonica, 2020

The incidence of anemia of chronic disease (ACD) is underestimated, increases with age, and affec... more The incidence of anemia of chronic disease (ACD) is underestimated, increases with age, and affects about 30% of the elderly. ACD treatment is currently based on the pharmacotherapy of diseases that caused anemia, erythropoiesis-stimulating agents, and parenteral administration of iron supplementation in case of iron deficiency. Increasing knowledge on the pathophysiology of ACD has resulted in the burst of research on the development of new drugs that are focused on three main areas. The first group of drugs includes substances that inhibit hepcidin transcription, namely direct and indirect bone morphogenetic protein 6 (BMP6) inhibitors and/or SMAD signaling pathway inhibitors, and drugs that regulate hepcidin transcription through STAT3 signaling pathway. The second group of drugs includes direct hepcidin inhibitors (e.g., aptamers, anticalin proteins, monoclonal antibodies) or substances that inhibit the binding of hepcidin to ferroportin. The third group of drugs improves erythr...

Postępy Mikrobiologii - Advancements of Microbiology, 2020

Severe acute respiratory syndrome coronavirus is a new infectious disease caused by a novel coron... more Severe acute respiratory syndrome coronavirus is a new infectious disease caused by a novel coronavirus (SARS-CoV-2). In February 2020 WHO renamed the disease to coronavirus disease 2019 (COVID-19). Coronaviruses belong to the family of Coronaviridae, order Nidovirales. Scientists have visualized the appearance of the SARS-CoV-2 using microscopic techniques, which has a crown-like shape and contains four structural proteins – S, E, M and N. ACE2 (angiotensin converting enzyme 2) is a receptor to which SARS-CoV-2 virus particles bind. The primary test to diagnose infection is the RT-PCR (Real time RT-PCR). Research is underway to identify vaccine against SARS-CoV-2 and therapeutic treatments for COVID-19. 1. Introduction. 2. Epidemiology and pathogenesis of the disease. 3. Molecular structure, division and origin of coronaviruses. 4. Coronavirus binding receptors. 5. Ways of transferring infection. 6. Symptoms and course of infection. 7. Preventive recommendations. 8. Characteristics...

Medical Science Monitor, 2020

Background: Biomarkers predicting the efficacy of treatment for locally limited prostate cancer a... more Background: Biomarkers predicting the efficacy of treatment for locally limited prostate cancer are greatly needed. This knowledge could improve the classification of patients for different methods of treatment and enable better recognition of groups with higher risk of biological recurrence. We prospectively assessed serial blood levels of apoptotic biomarkers and correlated them with response to treatment and clinical factors. Material/Methods: Blood was collected from 25 patients with prostate cancer before and after surgery, 16 healthy volunteers with benign prostatic hyperplasia (BPH), and 14 patients with metastasized disease. Immunoenzymatic methods were used to determine circulating apoptotic and inflammatory mediators, including tumor necrosis factor a (TNF-a), type I receptor (TNFRI), and type II receptor (TNFRII); FAS ligand (FasL); TNF-related apoptosis-inducing ligand (TRIAL); caspase 8 (Cas8); caspase 9 (Cas9); DNA methylation (metDNA); P-selectin; and high-sensitivity C-reactive protein. The total circulating fragments of cell-free DNA (cfDNA) were measured directly in serum. Results: Peripheral serum prostate-specific antigen increased rapidly together with cfDNA. A negative correlation was noted between tumor volume and TNFRI and TNFRII. Postsurgery P-selectin level was decreased, and metD-NA and TNFRII levels were increased. Three comparisons were made between patient groups: surgical vs. BPH; surgical vs. palliative; and palliative vs. BPH. TNFRI, TNFRII, metDNA, P-selectin, Cas8, and FasL were shown to have significant roles. Conclusions: The study indicated significant roles for cfDNA, both TNF receptors, metDNA, and P-selectin as serum biomarkers in patients with prostate cancer.

Acta Poloniae Pharmaceutica - Drug Research, 2019

At present, the only active substance of Gentian Violet (GV) is methylrosaniline ñ a triphenylmet... more At present, the only active substance of Gentian Violet (GV) is methylrosaniline ñ a triphenylmethane dye of which amino group contains 2 methyl groups. GV can be used to treat uncomplicated bacterial and/or yeast infections, support antibiotic therapy of more severe infections, but also to protect medical equipment against colonization by microorganisms. In the light of recent studies, there are many new possibilities for GV application. It has been shown to be effective in the treatment of viral infections, some chronic skin diseases and oncology. GV can induce apoptosis of tumor cells among others by elevating caspase 8, inhibiting NADPH oxidases, decreasing mitochondrial thioredoxin 2 or inhibiting STAT3/SOX2 axis. Preclinical and in vitro studies have also demonstrated GV efficacy in the treatment of breast cancer, melanoma tumors and cutaneous T-cell lymphoma. There is no unambiguous evidence indicating the toxicity of GV, whereas its safety has been proven by its long history of use, its inclusion in numerous guidelines and its legal trade and distribution with no specific approval requested in many countries around the world. The article gathers the available knowledge about GV and its potential use in the future.

Archives of Medical Science, 2019

Introduction: We aimed to analyze the prevalence of unexplained anemia (UA) and assess its charac... more Introduction: We aimed to analyze the prevalence of unexplained anemia (UA) and assess its characteristics, potential causes and impact on survival in an elderly population. Material and methods: Medical files of 981 patients aged ≥ 60 years consulted in one primary medical clinic in Poland in 2013-2014 were retrospectively analyzed. Anemia, defined according to WHO criteria, diagnosed during either hospitalization or outpatient treatment, from the age of 60, was included. Unexplained anemia was diagnosed if, based on available clinical data and laboratory tests and other assessments in medical records, none of the well-known types of anemia were identified. Results: Of 981 patients with anemia, UA was found in 48 (28.4%) patients (4.9% of those studied) and incidence increased with age (≥ 80 years, 12.3%). In 81.3% no full hematological diagnostics were performed. Patients with UA, as with those with defined anemia, when compared to the group without anemia were older, had more co-morbidities, were more frequently hospitalized, more frequently had dementia syndrome and obtained lower Barthel scores (p < 0.0001). In the groups of patients with UA and defined anemia, there were more deaths than in those without anemia (10% vs. 13% vs. 2%, p < 0.0001) with significant differences in survival rates observed during 3-year follow-up. Conclusions: The increasing incidence with age of UA in the elderly population, insufficient diagnosis and the higher mortality of patients with UA in comparison to the group without anemia indicate the need to develop recommendations for its management by primary care physicians.

Annals of Hematology, 2018

Anemia represents a common condition among the elderly; however, its prevalence and causes are no... more Anemia represents a common condition among the elderly; however, its prevalence and causes are not well known. This retrospective analysis was performed on 981 patients aged ≥ 60 in Poland over 2013-2014. The prevalence of anemia was 17.2% and increased with age. The predominant causes of anemia were the following: anemia of chronic disease (33.1%), unexplained anemia (28.4%), deficiency anemia (22.5%, including iron deficiency 13%), and chemo-/radiotherapy-induced anemia (8.9%). In the multivariate logistic regression model, factors increasing the risk of anemia were the following: age ≥

Psychiatria Polska

Anemia i depresja są powszechne u osób w podeszłym wieku i stanowią istotny problem medyczny, spo... more Anemia i depresja są powszechne u osób w podeszłym wieku i stanowią istotny problem medyczny, społeczny i ekonomiczny świata. Obydwa zaburzenia wiążą się z niską jakością życia, wielochorobowością, zwiększonym ryzykiem śmierci. Równoczesne występowanie anemii i depresji zostało potwierdzone w badaniach, ale mechanizmy i konsekwencje kliniczne tej koegzystencji nie zostały dotąd w pełni wyjaśnione. Istnieje szereg powiązań pomiędzy anemią a depresją takich jak wspólne czynniki etiologiczne, niski status socjoekonomiczny pacjentów, niskie wykształcenie oraz mniejsza aktywność fizyczna. W obydwu zaburzeniach stwierdza się te same patologiczne zmiany zależne od wieku (zwłaszcza obecność stanu zapalnego i stresu oksydacyjnego, zmiany degeneracyjne tkanek i narządów), niedobory żelaza czy witamin (B12, kwasu foliowego), zaburzenia hormonalne (zwłaszcza choroby tarczycy, niedobory hormonów płciowych). Zarówno anemia jak i depresja u osób starszych są w niewystarczającym stopniu rozpoznawan...

Psychiatria Polska

Anemia i depresja są powszechne u osób w podeszłym wieku i stanowią istotny problem medyczny, spo... more Anemia i depresja są powszechne u osób w podeszłym wieku i stanowią istotny problem medyczny, społeczny i ekonomiczny świata. Obydwa zaburzenia wiążą się z niską jakością życia, wielochorobowością, zwiększonym ryzykiem śmierci. Równoczesne występowanie anemii i depresji zostało potwierdzone w badaniach, ale mechanizmy i konsekwencje kliniczne tej koegzystencji nie zostały dotąd w pełni wyjaśnione. Istnieje szereg powiązań pomiędzy anemią a depresją takich jak wspólne czynniki etiologiczne, niski status socjoekonomiczny pacjentów, niskie wykształcenie oraz mniejsza aktywność fizyczna. W obydwu zaburzeniach stwierdza się te same patologiczne zmiany zależne od wieku (zwłaszcza obecność stanu zapalnego i stresu oksydacyjnego, zmiany degeneracyjne tkanek i narządów), niedobory żelaza czy witamin (B12, kwasu foliowego), zaburzenia hormonalne (zwłaszcza choroby tarczycy, niedobory hormonów płciowych). Zarówno anemia jak i depresja u osób starszych są w niewystarczającym stopniu rozpoznawan...