Introduction: The vitamin D receptor (VDR) gene is one of the most widely studied tumorigenesis-related genes. The primary objective of this study was assessment of possible roles of VDR gene polymorphisms in acromegaly, with regard to the activity of the disease and compared them with a control group. Furthermore, we have assessed the associations between these polymorphisms with vitamin D status as well as with TBS (trabecular bone score) and risk for osteoporotic fracture in acromegaly patients.Materials and Methods: We studied 69 patients with acromegaly and 51 healthy controls (CG). Acromegaly patients were divided into three subgroups on the basis of disease activity (AA, active acromegaly; CD, controlled disease; CA, cured acromegaly). In all patients, blood samples were obtained to assess the hormonal and metabolic status as well as genetic analysis. VDR polymorphisms were determined by means of two methods, Polymerase Chain Reactions (PCR) and minisequencing (SNaPshot).Results: Genotype frequencies for VDR ApaI, TaqI, BsmI, and FokI polymorphisms did not deviate significantly from Hardy-Weinberg equilibrium (HWE) in the acromegaly group as well as in the control group. There was no statistically significant difference in distributions of these four VDR genotypes between acromegaly patients and the control group. This study revealed statistically significant negative correlation between risk of major osteoporotic fractures and genotypes tt (TaqI), aa (ApaI) and bb (BsmI) in acromegaly groups. Furthermore, the negative correlations were observed between TBS and risk for major osteoporotic fractures and hip fractures.Conclusions: Our study suggests that tt (TaqI), aa (ApaI) and bb (BsmI) of VDR gene may be associated with better bone quality and microarchitecture (higher TBS), which lead to a lower risk of osteoporotic fractures in acromegaly patients. TBS may be a useful tool for predicting risk of fractures in acromegaly patients.

Asthma is a chronic inflammatory obstructive airways disease. The disease occurs regardless of age and manifests with cough, attacks of breathlessness, and tightness in the chest. The pathophysiology of asthma is complex and still not fully understood. It is essential to find answers concerning the role of each part of the bronchial tree in asthma, especially the role of small bronchioles. With the development of newer generations of multidetector computed tomography (MDCT) and advanced post-processing methods it is possible to obtain more detailed images and gain insight into further aspects of asthma. MDCT post-processing methods can be divided into two-dimensional (2D) and three-dimensional (3D). In 2D projections, visualized hypodense regions correspond to the airway flow limitations. With the more advanced methods, such as multi planar reconstructions (MPR), images in different planes (axial, coronal, or sagittal) can be created. In the MPR technique only the voxels which are adjacent to each other in the predetermined plane can be extracted from the data set. Using the minimal/maximal intensity projections and shaded surface display, the volume of interest (VOI) can be extracted. High resolution CT scans can be used to create a more advanced imaging tool - the virtual bronchoscopy (VB). Using the VB makes it possible to visualize regions of obturation in the bronchi of up to the 5-8th generation. The MDCT with advanced post-processing methods is likely to assume an important role in the differential diagnosis of asthma, particularly when the diagnosis is dubious or hard to settle due to accompanying other lung diseases.

BackgroundPatients with primary adrenal insufficiency need lifelong replacement therapy with glucocorticoids and mineralocorticoids, which may influence their bone quality.AimThe aim of the study was to evaluate densitometry parameters, trabecular bone score and sclerostin concentrations in patients with primary adrenal insufficiency in comparison to control group.Materials and methodsWe included 29 patients (62% females) with diagnose of autoimmune primary adrenal insufficiency (mean age 49.7 ± 11.7 years, mean duration of the disease 13.2± 13.6 years) and 33 healthy subjects (adjusted with age, sex and body mass index). Bone mineral density at the femoral neck, lumbar spine, total body and trabecular bone score were evaluated. Serum sclerostin concentrations were measured.ResultsThere were no significant differences in densitometry parameters (T-score, Z-score, bone mineral density in all locations) as well as in trabecular bone score in patients with adrenal insufficiency in comparison to control group. Mean serum sclerostin concentration was significantly higher in patients with adrenal insufficiency than in control group (44.7 ± 23.5 vs 30.7 ± 10.4 pmol/l, p=0.006). There was a negative correlation between trabecular bone score and the duration of adrenal insufficiency and age, also a negative correlation between femoral neck and total densitometry parameters and 24-hour urine cortisol as a marker of hydrocortisone daily dose in patients with adrenal insufficiency.ConclusionsThe bone status in patients with primary adrenal insufficiency was not impaired in comparison to control group, while sclerostin concentration was higher. The duration of the disease and higher hydrocortisone doses may affect negatively bone status.

A-koncepcja i projekt badania; B-gromadzenie i/lub zestawianie danych; C-analiza i interpretacja danych; D-napisanie artykułu; E-krytyczne zrecenzowanie artykułu; F-zatwierdzenie ostatecznej wersji artykułu Streszczenie Wprowadzenie. Obecnie nie ma wątpliwości odnośnie do konieczności podejmowania aktywności fizycznej przez kobiety zarówno przed ciążą, jak i w ciąży o fizjologicznym przebiegu. Polskie rekomendacje zwracają uwagę na ryzyko związane z aktywnością fizyczną i przedstawiają rodzaje ćwiczeń zagrażających ciąży. Cel pracy. Ocena aktywności fizycznej przed ciążą i w okresie ciąży oraz analiza zaleceń lekarzy prowadzących. Zbadano także popularność uczestnictwa w szkołach rodzenia, znaczenie wykonywanych ćwiczeń oddechowych i opinię ankietowanych o efektywności poszczególnych rodzajów aktywności fizycznej w ciąży. Materiał i metody. Materiał stanowiły dane zebrane na podstawie autorskiej ankiety składającej się z 25 pytań, skierowanej do kobiet w ciąży lub tych, w przypadku których nie upłynęło więcej niż pół roku od porodu. Badaniem objęto 201 kobiet. Wyniki. U 46% respondentek nastąpiło zmniejszenie aktywności fizycznej po zajściu w ciążę, a u 10%-zwiększenie. Wśród ankietowanych, które były w planowanej ciąży 7% ograniczyło aktywność fizyczną, a 10% zwiększyło. Przed zajściem w ciążę ponad połowa ankietowanych była umiarkowanie aktywna fizycznie (70%). Po zajściu w ciążę odsetek nieuprawiających aktywności fizycznej zwiększył się o 23% w porównaniu z okresem sprzed ciąży. W ciąży największą popularnością cieszyły się: pilates, aqua aerobic i specjalne zajęcia dla ciężarnych. 49% ankietowanych nie rozmawiało ze swoim lekarzem o aktywności fizycznej w czasie ciąży i tyle samo respondentek uczestniczyło w zajęciach szkoły rodzenia. Aż 90% kobiet wyraziło przekonanie, że aktywność fizyczna w czasie ciąży korzystnie wpływa na stan zdrowia kobiety i jej dziecka. Wnioski. Istnieje powszechna opinia wśród kobiet o korzystnym wpływie ćwiczeń fizycznych w ciąży na stan matki i dziecka. Zbyt mało lekarzy położników informuje swoje pacjentki o możliwych do wykonywania ćwiczeniach u ciężarnych. Konieczne jest uaktualnienie zaleceń Polskiego Towarzystwa Ginekologicznego dotyczących najlepszych rodzajów i sposobów ćwiczeń dla kobiet w ciąży o prawidłowym przebiegu (Piel. Zdr. Publ. 2016, 6, 2, 143-147).

A -study Design, B -Data collection, C -statistical analysis, D -Data Interpretation, E -Manuscript Preparation, F -literature search, G -funds collection Background. arterial hypertension is an essential, often underestimated medical problem among school youth. Maintaining a low blood pressure (BP) in children should be an important point of pediatric preventive healthcare. Objectives. In our study, we considered the influence of physiotherapy on the blood pressure level in a group of 233 children aged from 8 to 15 years taking part in a rehabilitation camp for children in the szklarska Poreba mountain resort (95 children in 2014 and 138 children in 2015). Material and methods. the children selected for the study suffered from asthma or recurrent respiratory infections. Measurements were made before and after physiotherapy. During the camp, the children were examined two times in 2014 and three times in 2015. the database created contained 1,208 scores of systolic and diastolic BP. the control group consisted of 50 children whose BP was measured in the same hours, but during the weekend, which was free of physiotherapy. Moreover, the values of heart rate (hr) during the first measurement were recorded, both in 2014 and 2015. Results. systolic BP after physiotherapy was significantly lower than before. this result was achieved in every five measuring sessions. In the control group, BP measured in the afternoon was higher than in the morning. the values of hr were not significantly different. the values of BP before and after physiotherapy between children treated with inhaled glucocorticoids and treated without glucocorticoid were not statistically significant. Conclusions. our studies showed that morning exercise can significantly reduce blood pressure in children throughout the day, even in those who were treated with inhaled glucocorticoids. Key words: children, blood pressure, hypertension, exercise, adolescents. Summary ISSN 1734-3402, eISSN 2449-8580this is an open access article distributed under the terms of the creative commons attribution-noncommercial-sharealike 4.0 International (cc By-nc-sa 4.0). License (http://creativecommons.org/licenses/by-nc-sa/4.0/). Pirogowicz I, ornat M, jerczak B, Pachołek K, Domeredzka P, Gojny ł. the influence of physiotherapy on blood pressure in children and adolescents with respiratory tract diseases.