Wprowadzenie Dializoterapia jest leczeniem ratującym życie u pacjentów ze schyłkową niewydolnością nerek, jednak wiąże się z licznymi obciążeniami somatycznymi, funkcjonalnymi i psychospołecznymi. Mogą one utrudniać adaptację do choroby przewlekłej. Akceptacja choroby stanowi istotny zasób psychologiczny, sprzyjający lepszemu funkcjonowaniu, dobrostanowi oraz zaangażowaniu pacjentów w proces leczenia. Cel pracy Celem badania była ocena poziomu akceptacji choroby u pacjentów dializowanych w Polsce oraz analiza jej związku z ograniczeniami funkcjonalnymi, wybranymi czynnikami klinicznymi i socjodemograficznymi. Materiał i metody Badanie miało charakter przekrojowy i zostało przeprowadzone w 99 stacjach dializ na terenie Polski w latach 2023–2024. Objęto nim dorosłych pacjentów poddawanych hemodializie lub dializie otrzewnowej. Poziom akceptacji choroby oceniano z wykorzystaniem Skali Akceptacji Choroby (AIS; 8–40 punktów). Informacje dotyczące ograniczeń funkcjonalnych uzyskano na podstawie pytania otwartego, a następnie poddano je analizie tematycznej. Analizę statystyczną oparto na testach nieparametrycznych oraz współczynniku korelacji Pearsona. Wyniki i wnioski Analizie poddano 887 kwestionariuszy. Średni wynik AIS wyniósł 24,84±7,71, co wskazuje na umiarkowany poziom akceptacji choroby. Większość kategorii ograniczeń funkcjonalnych nie była istotnie związana z AIS. Wyższe wyniki odnotowano u pacjentów zgłaszających ograniczenia w podróżowaniu. Nie wykazano związku między AIS a metodą dializy ani rodzajem dostępu naczyniowego. Stwierdzono słabą ujemną korelację z czasem trwania dializoterapii. Osoby pozostające w związku małżeńskim miały wyższy poziom akceptacji, natomiast pacjenci posiadający dzieci – niższy. Akceptacja choroby u pacjentów dializowanych w Polsce jest umiarkowana i nieznacznie obniża się wraz z czasem leczenia. W niewielkim stopniu zależy od czynników klinicznych, a większe znaczenie mają wybrane uwarunkowania socjodemograficzne i subiektywnie odczuwane ograniczenia.
This paper aims to identify the dental prevention and treatment needs of patients with cystic fibrosis (CF) and suggest implementation of dedicated dental health standards for such patients. Oral bacterial microbiota are a part of the upper respiratory tract microbiota, which is of crucial importance, especially for patients at risk of respiratory auto-infection. Parents and, later, patients themselves are not always aware of the harmful impact of the ongoing pathologies in the oral cavity on the whole body. Hence, educating on how to counteract auto-infection is necessary. CF patients are a group that require targeted dental care, and a dentist should be a member of a multi-specialist patient-care team. To improve the oral health of CF patients, it is advisable to implement overall solutions involving targeted preventive and therapeutic measures. Presented oral health standards of CF patients may affect their general health and quality of life.
Introduction Fetal inflammatory response syndrome (FIRS) is observed in preterm infants, characterised by inflammation of the umbilical cord and elevated levels of pro-inflammatory cytokines in circulation. Aim of the research To assess pentraxin 3 (PTX3) as a sensitive biomarker for the early detection of FIRS in preterm infants. Material and methods This prospective study was conducted at the Department of Neonatology, from September 2008 to March 2009, with the inclusion of 63 preterm infants (gestational age: 28–36 weeks) in the Neonatal Intensive Care Unit (NICU). Data were collected on demographics and clinical history, and infections were assessed based on clinical findings and laboratory results. FIRS was defined by IL-6 levels exceeding 11 pg/ml in umbilical vein blood to categorise the infants into FIRS-positive and FIRS-negative groups. Results It was determined that 46.1% of the infants with RDS and 19.2% of those with neonatal pneumonia were FIRS positive, indicating a statistically significant relationship between these conditions and FIRS positivity (p < 0.05). PTX3 levels in cord blood were significantly higher in the FIRS-positive infants compared to the FIRS-negative infants (p = 0.001). IL-6 levels were also elevated in the FIRS-positive group, especially in cord blood (p = 0.001). TNF-α levels did not differ significantly between the groups. PTX3 and sepsis were significant predictors of FIRS positivity, with PTX3 having an OR of 1.131 (95% CI: 1.026–1.246, p < 0.05). PTX3 levels had a cutoff value of > 4.45 (AUC = 0.76, 95% CI: 0.64–0.86, p < 0.001). Conclusions PTX3 can serve as a useful biomarker for detecting FIRS, and PTX3 levels appear to be linked to conditions such as RDS and sepsis.
Introduction Synchrotron radiation enables precise imaging of biological structures at the subcellular level, providing insight into both elemental composition and chemical properties. Increasing evidence suggests that its application in otolaryngology – particularly in the diagnosis of laryngeal cancer – may offer valuable support to existing diagnostic methods and deserves further development and implementation in translational research. Aim of the research To evaluate the potential of synchrotron X-ray radiation in otolaryngology based on a literature review and to present findings from a pilot study using X-ray absorption spectroscopy (XAS) in laryngeal cancer samples. Material and methods A literature review was conducted following PRISMA guidelines using databases such as PubMed, Medline, and Google Scholar. Experimental studies were carried out at the SOLARIS National Synchrotron Radiation Centre on samples of laryngeal squamous cell carcinoma using XAS (TEY and TFY modes) and scanning transmission X-ray microscopy (STXM) for elemental mapping. Results The review confirmed the effectiveness of synchrotron-based techniques (XAS, STXM, µXRF) in subcellular imaging. In the examined cancer samples, a predominance of Fe³⁺ was observed, indicating oxidative stress. STXM imaging revealed heterogeneous distribution of elements (C, N, O, Fe), reflecting the biochemical complexity of the tumour. Synchrotron techniques enable the assessment of iron redox alterations as potential cancer biomarkers. They support early diagnosis and expand our understanding of tumour pathophysiology. Conclusions The presented findings highlight the need for further research to facilitate the clinical translation of these methods.
Introduction Obesity is a known variable associated with increased risk of atrial fibrillation (AF); however, the impact of body mass index (BMI) on adverse cardiovascular outcomes in individuals with AF taking anticoagulants is not well established. Aim This study aimed to evaluate the association between BMI categories (normal weight, overweight, and obese) and adverse cardiovascular outcomes in individuals with AF taking anticoagulants. Material and methods This prospective, observational, long-term follow-up cohort study included 500 individuals with AF who underwent transoesophageal echocardiography before electrical cardioversion. Individuals were stratified by BMI and followed up for a median of 1927.5 days. Endpoints included major cardiovascular events (stroke, myocardial infarction, transient ischaemic attack, systemic thromboembolism, hospitalisation for heart failure, and cardiovascular death) and left atrial appendage thrombus (LAAT). Results Adverse cardiovascular event rates were similar across BMI categories. Individuals with normal weight presented with fewer comorbidities, such as diabetes mellitus and arterial hypertension, and demonstrated more favourable echocardiographic measurements, including smaller left atrial diameters. Despite these differences, no significant variations in LAAT prevalence or other adverse cardiovascular outcomes were observed between the BMI groups. BMI did not significantly influence long-term adverse cardiovascular outcomes or LAAT in individuals with AF taking anticoagulants. The low proportion of normal-weight individuals in the cohort suggests a potential protective role of normal weight against AF. Conclusions Further research is required to understand the complex interplay among BMI, comorbidities, and cardiovascular risk. These findings question the utility of BMI as a standalone risk predictor in this population.
Introduction Skills in correctly performing cardiopulmonary resuscitation (CPR) are a key predictor of its effectiveness. Both the acquisition of appropriate skills during training and regular practice significantly impact the accuracy of CPR execution, both in real-life scenarios and simulated conditions. Aim of the research The study aimed to assess the quality of CPR performed by various professional groups. Factors that could statistically significantly influence the quality of resuscitation procedures and the overall outcome of the exercises were investigated. Material and methods A retrospective analysis was conducted on data collected during training sessions using a Laerdal QCPR manikin equipped with a real-time quality feedback system for CPR. The gathered data were subjected to statistical analysis using PQStat software. Results The study sample included 49 participants: 20 nurses, 16 paramedics, and 13 firefighters. Statistically significant differences were observed in CPR quality between the groups of nurses and paramedics, as well as between nurses and firefighters (p = 0.00567 and p = 0.005291, respectively). Additionally, it was noted that male participants performed CPR better than female participants (p = 0.020456). A statistically significant difference in the change in mean arterial pressure due to physical exertion was observed between nurses and paramedics (p = 0.012518). Conclusions Different professional groups demonstrate varying predispositions for achieving high-quality results in CPR procedures. The gender of individuals performing CPR influences the quality of execution. The BMI index does not affect CPR performance quality.
Introduction Cervical cancer is one of the most common malignant tumours among women worldwide. Cytology remains the simplest and cheapest method for detecting this cancer. Due to the very low participation of women in cytological screening, the disease is often diagnosed at an advanced stage. Aim of the research The aim of the study has been to estimate how the COVID-19 pandemic and related public life restrictions affected cervical cancer screening during the period from March 2018 to February 2024. Material and methods The research sample consisted of cytological test results. An analysis was conducted on patient attendance for cytological screening as well as an analysis of positive results during the periods before, during, and after the COVID-19 pandemic. Results The COVID-19 pandemic and the associated public restrictions negatively impacted the performance of cytological tests only ‘outside the programme’. However, what is particularly noteworthy is that the number of tests performed ‘as part of the prevention programme’ has increased. Despite the decreasing number of tests performed after the pandemic, we observed a higher percentage share of positive diagnoses (period VI: 2.24%). LSIL diagnoses are starting to prevail, which carries the risk of the development of higher-grade lesions over time. Conclusions The pandemic determines the risk of the occurrence of high-grade intraepithelial lesions and cervical cancer. It is necessary to implement changes in cytological screening as soon as possible to increase the rate of cytology tests, not only during such a challenging time as the pandemic but also beyond it.
The Polish legal system has limited experience in developing out-of-court models of compensating medical injuries. This situation began to change gradually in the second decade of the 21st century with the introduction of the so-called regional commissions for medical events in Polish law. The new solutions allowed people to claim compensation and redress for so-called medical events without the need to go to court. These legal changes, along with rapid economic and social development and a new approach to the role of the state, led to the introduction in Polish law of the so-called compensation funds, including the Vaccination Compensation Fund, the Clinical Trials Compensation Fund, and the Medical Event Compensation Fund. Each fund was created under different circumstances and serves a distinct purpose, and Poland has not yet established a single, unified model for compensating medical injury. The purpose of this article is to examine how these funds operate.
Wprowadzenie Lipoproteina(a) [Lp(a)] to cząsteczka lipidowa podobna do cholesterolu lipoprotein o niskiej gęstości (LDL-C). Podwyższony poziom Lp(a) jest związany ze zwiększonym ryzykiem miażdżycy. Cel pracy Celem badania jest przesiewowa analiza poziomów Lp(a) u pacjentów przyjętych do Kliniki Chorób Wewnętrznych, niezależnie od tego, czy hospitalizacja była związana z przyczynami kardiologicznymi, czy niekardiologicznymi. Materiał i metody Materiały i Metody Badaniem objęto 104 pacjentów hospitalizowanych w Klinice Chorób Wewnętrznych i Farmakologii Klinicznej w okresie od 2 lipca 2021 r. do 3 grudnia 2021 r., z wyłączeniem osób przyjętych z powodu zakażenia SARS-CoV-2. Pacjentów analizowano pod kątem obecności miażdżycy, poziomu Lp(a) oraz innych parametrów laboratoryjnych. Podzielono ich na dwie grupy: pacjentów przyjętych z powodów kardiologicznych oraz pacjentów hospitalizowanych z innych przyczyn. Wyniki i wnioski Wyniki: Do grupy pacjentów przyjętych z powodów kardiologicznych zakwalifikowano 46 osób, natomiast do grupy hospitalizowanej z innych przyczyn – 58 osób. Analizując poziomy Lp(a) w obu grupach, stwierdzono, że u 14 z 46 pacjentów (30,4%) hospitalizowanych z powodów kardiologicznych występował podwyższony poziom lipoproteiny ≥75 nmol/l. W grupie pacjentów przyjętych z przyczyn niekardiologicznych podwyższone wartości Lp(a) stwierdzono u 13 z 58 osób (22,4%). Oprócz poziomu HDL nie stwierdzono istotnych różnic pomiędzy obiema grupami. Wnioski: Uzyskane wyniki podkreślają znaczenie powszechnego badania przesiewowego poziomu Lp(a), szczególnie u osób bez objawów miażdżycy, w celu identyfikacji osób zagrożonych jej rozwojem.
Introduction Analysis of the coexistence of multiple renal arteries and veins is a rare subject in the literature. There are few studies in which the arterial and venous systems of the human kidney are evaluated simultaneously. Aim of the research: The aim of the study was to analyse and correlate variations in the arterial and venous vascularisation of the kidneys in patients diagnosed using computed tomography. Material and methods The study group (1196 patients) included women (592) and men (604), aged from 19 to 92 years, who had imaging scans performed using contrast-enhanced computed tomography. The statistical analysis was performed using Statistica 12.0 software. The relationships were verified with the c2 test. The level of statistical significance was p = 0.05. The mean age of the patients was 58.78 ±15.31 years; the mean age for men was 57.18 ±14.74 years, and for women 60.41 ±15.72 years (p < 0.001). Results As for arterial vascularisation, it was demonstrated that the presence of multiple renal arteries was more common in left kidneys (11.71%) compared with right kidneys (9.95%), whereas multiple renal veins more often occurred in right kidneys (9.03%) than in left kidneys (4.43%). It was generally concluded that there is a correlation between the number of coexisting arteries and veins in the kidneys, which was confirmed statistically (c2 = 55.47; p < 0.001). In the context of anatomic variation regarding the extrarenal arteriovenous system of the kidneys, there is a statistical relationship between the number of coexisting arteries and veins in the kidneys (r = 0.9472; p < 0.001), which has been confirmed by the results of this study.
