Aim. The aim of this study was to evaluate the incidence of diabetic ketoacidosis in children and adolescents with newly diagnosed type 1 diabetes in 2006-2007 and 2013-2014. Method. The study group consisted of 426 children aged 0–18 years with type 1 diabetes onset admitted to our hospital in 2006-2007 (group A) and 2013-2014 (group B). The study comprised the analysis of medical and laboratory records from patients' medical charts and the electronic database. Results. There was no difference between groups A and B in the percentage of children admitted with diabetic ketoacidosis (25% versus 28%, resp., P = 0.499). Among children with diabetic ketoacidosis, severe metabolic decompensation (pH < 7.1) appeared in similar frequency in groups A and B (28% versus 30%, resp., P = 0.110). In group B, children with diabetic ketoacidosis were statistically younger compared to patients without ketoacidosis (P = 0.015) and had higher HbA1c levels (P = 0.006). In both groups, a 2-fold increase in diabetic ketoacidosis was noted in children under the age of 3, compared to overall frequency. Conclusion. No decrease in diabetic ketoacidosis has been noted in the recent years. Although the prevalence and severity of diabetic ketoacidosis remain stable, they are unacceptably high. The youngest children are especially prone to ketoacidosis.

Introduction: The hypothalamic-pituitary-adrenal (HPA) axis plays a crucial role in systemic homeostasis and hormonal regulation of metabolic and immune functions. A similar HPA axis analog exists in the skin, where it regulates inflammation, cell proliferation and differentiation. Data regarding central HPA axis dysregulation in psoriasis are interesting but so far inconclusive. Aim: In the study we attempted to determine whether central HPA axis serum components correlate with psoriasis severity. Material and methods: Forty-two patients (10 women and 32 men) hospitalized at the Department of Dermatology participated in the study. None of our patients received any systemic treatment. Venous blood samples were collected at 6.00 AM. The relationship between quantitative variables and psoriasis severity based on the Psoriasis Area and Severity Index (PASI) was assessed with proc logistic in SAS 9.4. Results: The effect of adrenocorticotropin/cortisol ratio on the PASI group was OR 3.621 (95% confidence limits 1.217-10.775) for a 0.1 change in ratio (p = 0.02), meaning ACTH/cortisol ratio positively correlates with psoriasis severity. The effect of ACTH and cortisol on the PASI group was not statistically significant, with p-values of 0.30 and 0.23 respectively. Other inflammatory markers such as high-sensitivity C-reactive protein, neutrophils level, LDL, and total cholesterol did not show a significant correlation with PASI score. Conclusions: Our results support the role of HPA axis dysfunction in the complex pathogenesis of psoriasis, showing a positive correlation between morning ACTH/cortisol ratio and disease severity. ACTH/cortisol ratio can be regarded as a new biochemical marker of psoriasis severity worth further studies.

Skin provides protection against external agents and plays an essential role in maintaining the body homeostasis. Bioprinting as a novel strategy involves computer-controlled deposition of cells and scaffolds into a three-dimensional (3D) construction of skin. 3D bioprinting gives an opportunity to generate multi-layered vascularized skin grafts that can overcome the limitations of current skin substitutes. The main indication is treatment of troublesome wounds, especially severe burns and non-healing chronic lesions. Bioprinted skin equivalents offer a promising approach in the field of regenerative medicine. This review presents and discusses 3D skin construct formation, its limitations and modifications, and its usefulness.

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Introduction. Psoriasis is associated with symptoms of the metabolic syndrome. Adipokines are bioactive mediators secreted by adipose tissue. They influence inflammatory reactions, insulin resistance, diabetes and atherosclerosis. Alterations in serum levels of some adipokines have been reported in patients with psoriasis. Objective. A cross-sectional study was performed to better understand the role of adipokines in psoriasis, by assessing their levels and relationship with disease severity. Material and methods. Serum fasting levels of six different adipokines-adiponectin, leptin, visfatin, resistin, chemerin, and retinol binding protein 4 (RBP4)-were measured in 42 patients with psoriasis and correlated with the Psoriasis Area and Severity Index, body surface area, body mass index, waist-hip ratio and lipid parameters. Results. The results showed that adipokines did not correlate with psoriasis severity, with the exception of RBP4 concentration, which showed a statistically significant difference between patients with mild, moderate and severe psoriasis. RBP4 was elevated in moderate and severe psoriasis, what can correspond with the therapeutic effect of retinoids in psoriasis depending on fat tissue capacity. Significant negative correlations was observed between adiponectin/leptin ratio and following parameters: with body mass index (p < 0.0001), waist-hip ratio (p = 0.04) and visceral fat (p = 0.0001) and a correlation with HDL cholesterol (p = 0.0005). A total of 83.3% (35/42) showed an adiponectin/leptin ratio below 0.5, which isindicative of high cardiometabolic risk. Conclusions. To the best of our knowledge, this is the first study assessing six different adipokines in sera of patients with psoriasis and their correlation with disease severity and metabolic syndrome components, showing increased cardiovascular risk in patients with psoriasis, based on the adiponectin/leptin ratio.