Objective. The aim of the study was to assess the reactivity of the cutaneous microcirculation in patients with arterial hypertension (AH), taking into account the intake of anti-hypertensive drugs, using laser doppler flowometry (LDF) and the post-occlusive reactive hyperaemia (PORH) test. Materials and method. The analysis included 44 patients with well-controlled AH, and 22 subjectively healthy volunteers aged 23 -74 years, matched with the study group. During the study period, 22 patients in the study group were taking ACEI drugs, also in combination with other drug groups in terms of gender and age. 19 patients were taking other groups of drugs, including: ARB, beta-blockers, alpha-blockers, CCB, diuretics, also in combination, while 3 patients were not taking medication for AH; they were recommended non-pharmacological treatment. Blood biochemical tests, ambulatory blood pressure monitoring (ABPM) and PORH test using LDF were performed.Results. The study showed that the PORH flow parameters were not differ statistically significantly between the study and control groups (p> 0.05). Statistically significant differences were shown in the PORH maximum level (ML) on the skin forearm between the study group not taking ACEI drugs and the control group. No statistically significant differences were shown between the study group taking ACEI and the control group. Conclusions. The pathogenesis of AH is multifactorial and depends, inter alia, on disturbances at the level of microcirculation. Proper treatment, especially with the use of ACEI, can improve the microcirculation in AH patients.

Wprowadzenie i cel pracy. Krążące komórki śródbłonka (CECs) są to komórki, które pojawiają się we krwi obwodowej na skutek złuszczania się śródbłonka naczyń w przebiegu schorzeń układu sercowo-naczyniowego, nowotworów, zakażeń czy zapaleń. U osób zdrowych komórki te nie występują we krwi obwodowej lub ich liczba jest bardzo mała. Celem prezentowanej pracy jest podsumowanie doniesień dotyczących CECs-chorób, w przebiegu których dochodzi do wzrostu liczby tych komórek we krwi obwodowej oraz sposobów ich detekcji. Skrócony opis stanu wiedzy. CECs możemy obecnie uznać za wiarygodny, nieinwazyjny marker uszkodzenia śródbłonka naczyń. Liczba tych komórek jest podwyższona w wielu schorzeniach przebiegających z dysfunkcją śródbłonka takich jak: ostry zespół wieńcowy, zapalne choroby naczyń, zakażenia, cukrzyca, obturacyjny bezdech senny czy nowotwory. W badaniach dowiedziono również, że liczba CECs koreluje z zaostrzeniem choroby i jej rokowaniem. Przy pomocy oceny liczby CECs obserwuje się odpowiedź na terapię, także przeciwnowotworową. Do izolacji CECs stosowane są obecnie dwie metody-immunomagnetyczna oraz z wykorzystaniem cytometrii przepływowej. Podsumowanie. Określenie liczby CECs we krwi obwodowej staje się pomocne w ocenie klinicznej chorób, prognozowaniu ich przebiegu oraz w ocenie skuteczności stosowanego leczenia. Istotne wydaje się prowadzenie dalszych badań nad występowaniem CECs w różnych schorzeniach oraz ujednolicenie metod ich detekcji z krwi obwodowej.

Wegener's granulomatosis is an autoimmune disease characterized by necrotizing granulomatous inflammation of small vessels. This condition concerns the upper and lower airways, kidneys, and eyes. In 50% of cases the disease affects skin, leading to the formation of non-healing skin ulcers. In this article, the case of a 23-year-old patient is presented who was diagnosed with Wegener's granulomatosis on skin around the right outer ear, infiltration of the mucosa of the mouth and facial asymmetry. In treatment, apart from steroid pulses and immunosuppressive therapy, hyperbaric oxygen therapy was used, which led to a very good therapeutic effect, and total regression of skin lesions.

Kuczyńska M, Dziaduch E, Grzywa-Celińska A, Lachowska-Kotowska P, Mosiewicz J. Lethal acute liver failure in a 60 y/o female patient with AILD III (Ann Arbor) T-cell lymphoma in remission state -Case report. J Pre-Clin Clin Res. 2014; 8(1): 41-43. AbstractAcute liver failure (ALF) is a rare condition in which liver function deteriorates suddenly, leading to encelopathy and coagulopathy in patients previously unaffected with hepatic cirrhosis. The case is presented of a 60-year-old woman admitted to our Department with complaints of general malaise, excessive sweating and body temperature elevation. Her history was relevant in terms of T-cell lymphoma in remission, hypertension and paroxysmal atrial fibrillation. The patient only reported using methylprednisolone in 4-8 mg daily dosage. Liver function tests were abnormal, with considerably elevated ALT, AST and GGTP concentrations. Diagnostic imaging revealed non-dilated biliary ducts, hepatomegaly and a single enlarged lymph node between the inferior vena cava and hepatic portal vein. A needle biopsy of the liver was nondiagnostic due to protein masses blurring the specimen. Autoimmune markers and investigation for Wilson's disease both presented no alterations. The patient presented hyperthyroidism with no signs of thyrotoxicosis, significant leukocytosis with granulocytosis and thrombocytopenia. Her state deteriorated rapidly despite aggressive pharmacological treatment. The patient died before a needle core biopsy could be performed; no post-mortem examination was carried out at the request of the family. ALF should be suspected in every patient who exhibits highly elevated hepatic enzymes and whose condition is deteriorating rapidly. In our investigation, we should primarily focus on histopathological examination and qualifying the patient for the liver transplantation.

No abstract