INTRODUCTION:The aim of this study was, with regard to the state of Poland's pediatric healthcare, to assess user experiences from the perspective of caregivers of pediatric patients and to provide a comprehensive picture of its quality. The research involved cooperating pediatric oncology and hematology wards across Poland. DESIGN:Cross-sectional, multicentre instrument validation study and caregiver's experience survey in Poland. METHODS:In-patient study was conducted at 14 pediatric oncology and hematology wards. The cooperating wards represented all of Poland's voivodeships, and the study was coordinated by trained nurses. The reliability and validity of the research conclusions were obtained based on assessments provided by a representative population of 813 (adult) primary caregivers of pediatric patients. Two tools were used: the Pediatric Patient Experience Questionnaire (PPEQ) (the Polish adaptation of the CAHPS Child Hospital Survey (Child HCAHPS)); collected sociodemographic and clinical data. RESULTS:The highest percentage of Top Box scores, 84.30%, was recorded for the "Responsiveness to the call button", and the lowest for "Preventing mistakes and helping you report concerns" (25.66%). The presence of verified hospital infrastructure elements ranged from 85% to 99%. Moreover, 68.39% of all respondents gave the Top Box rating to the pediatric oncology and hematology hospital where their child was treated, and 63.22% stated that they would recommend it. CONCLUSIONS:Overall, the quality of healthcare in Poland's pediatric oncology and hematology centers is high. Caregivers evaluated hospitals mainly based on staff communication with the child and caregiver-and on the sense of comfort during the stay. The aesthetics of the interior and accessibility for people with special needs were also important, while ensuring comfort and safety remains an area for improvement. CLINICAL RELEVANCE:The use of the PPEQ supports the development of healthcare based on communication, empathy, and partnership with pediatric patients and their families, notably their primary caregivers. Frequent measurement of experiences can provide reliable guidance on adjustments that should be made to the healthcare system.

Quality of life is an important indicator that should be treated on par with medical health indicators. Among COVID-19 survivors, a decline in quality of life is often observed due to persistent, long-term symptoms affecting physical and mental functioning, as well as social activity. A major factor improving the quality of life and health of patients is multidimensional rehabilitation. The aim of the presented study was to analyze changes in quality of life and self-assessment of health status influenced by rehabilitation, the quality of life of patients after rehabilitation, and the health problems experienced by COVID-19 survivors. A self-authored questionnaire and the WHOQOL-BREF scale were employed in the study. Questionnaires were collected from a total of 166 patients who had been diagnosed with a positive COVID-19 test and had undergone rehabilitation after recovery. It was found that the respondents most frequently experienced cognitive, musculoskeletal and respiratory disorders. Moreover, a positive impact of rehabilitation on the quality of life (p<0.001) and health status (p<0.001) of recovered patients was demonstrated. Rehabilitation, with particular emphasis on therapeutic exercises and respiratory rehabilitation, is therefore an important factor in improving the functioning of patients and their ability to perform daily activities.

Knowledge and skills in Basic Life Support (BLS) resuscitation procedures are essential for the correct recognition of circulatory arrest and the implementation of rapid management, resulting in increased survival rate of the victim. Numerous techniques for teaching cardiopulmonary resuscitation (CPR) are being used, yet there is insufficient data on the effectiveness of using virtual reality (VR). The aim of the study was to evaluate the short- and three-month didactic effect in teaching BLS procedures and chest compressions using modern virtual reality (VR) technology. A total of 205 subjects were included in the study, assigned by randomized controlled design to a study group (A) implementing VR training and a control group (B) participating in traditional training. The participant group consisted of 73.91

Background: Incidence of breast cancer (BrCa) may be correlated with country development, with a rise in cases anticipated in regions of the world that are currently undergoing an economic transformation. Herein, differences with regard to the occurrence of breast cancer between individual countries may depend on the distribution of risk factors, the level of early detection, also ethnicity and race, as well as clinical characteristics. The aim of our study was to identify and then investigate observational studies in which the risk of breast cancer was associated with the use of oral hormonal contraceptives (OCs), with particular emphasis on geographic region, and to conduct a systematic review and meta-analysis of the obtained data. Methods: RR (relative risk) was calculated and displayed in forest plots for visual interpretation. Accordingly, 74 studies involving a total of 198,579 women were eligible for inclusion in the meta-analysis. This is the first meta-analysis to comprehensively summarize the evidence between OC use and BrCa risk in connection with geographical region. Results: The cumulative results of the meta-analysis for specific parts of the world are: Africa (RR = 1.16, p = 0.216) and the Americas (RR = 1.03, p = 0.597); Asia (RR = 1.29, p = 0.014); European countries (RR = 1.01, p = 0.904); and Middle East countries (RR = 1.29, p = 0.043). Subgroup analyses showed an increased risk of BrCa for the analyzed variables that depended upon the geographical region. Conclusions: Our meta-analysis suggests that OC use may be associated with a higher BrCa risk, although a statistically significant association was not found for all geographical regions of the world.

AbstractEndometrial cancer is one of the most common gynaecological cancers in the developed countries. The aim of this study was to determine the impact of hypertension on endometrial cancer risk. Databases: PubMed, Embase and the Cochrane Library were searched from January 2000 to June 2024. We used DerSimonian-Laird random-effects model for analysis. Risk estimates were extracted by two authors and summarized using meta-analytic methods. A total of 26 observational studies with 207,502 endometrial cancer cases were included in the study. Overall meta-analysis demonstrates significant association between hypertension and endometrial cancer risk (RR = 1.37, 95% CI: 1.27–1.47, p < 0.001). Subgroup analysis of the risk of endometrial cancer shows statistically significant higher risk in patients with BMI ≥ 30 kg/m2, diabetics, women who had their first menstrual period at the age of 11 years or earlier, and who had never given birth. Findings of this comprehensive review and meta-analysis indicate that hypertension is associated with higher overall risk of endometrial cancer.

Plants belonging to the genus Cotoneaster can be valuable sources of phytochemicals with potential therapeutic properties. The natural habitats of most of these species are situated in Asia, Africa and southern Europe. Introducing them into other climatic conditions could expose them to abiotic and biotic stresses, affecting their bioactive properties. The aim of this study was to assess and compare the performance of four non-native Cotoneaster species (C. roseus, C. hissaricus, C. hsingshangensis, C. nebrodensis) grown in eastern Poland in terms of leaf morphology, anatomy, and efficiency of the photosynthetic apparatus in relation to lipid peroxidation level, being an indicator of oxidative stress. Photosynthetic pigments concentration and chlorophyll a fluorescence parameters were used to evaluate the photosynthetic capacity. The morphological and anatomical analysis of leaves did not show any anomalies or stress symptoms. Cotoneaster roseus was characterized by the highest chlorophyll concentration, viability index (Rfd) and a moderate lipid peroxidation level. On the other hand, the lowest values of photochemical quenching (qP), maximum fluorescence (Fm), Rfd, and quantum yield of the photosystem II (QY) observed for C. nebrodensis might indicate an inferior efficiency of the photosynthetic apparatus in this species; however, it demonstrated the lowest lipid peroxidation level. Nevertheless, the content and proportion of the photosynthetic pigments as well as overall chlorophyll a fluorescence parameters and lipid peroxidation levels indicate a good physiological condition of all examined plants. The observed differences between the species may be rather species specific and genetically established and not indicate their sensitivity to non-native growth conditions. This is the first report about the physiological parameters of the four Cotoneaster species, proving they are well adapted to growth in the climatic conditions of central Europe providing thus a raw material with potential for pharmaceutical applications.

Background: The World Health Organization (WHO) estimates that 180,000 patients die from burns every year, which is considered a serious public health issue. Patients with burns require immediate pre-hospital care and transport to specialized treatment facilities. The aim of this study was to outline the profile of the burn patient from the perspective of the Polish Medical Air Rescue (PMAR), as well as to analyze the medical procedures being implemented. Methods: The study includes 2154 interventions by air emergency medical teams (AEMS) which provided aid for burn patients. The analysis covered the period from 2018 to 2022, including nationwide data made available from the IT systems of the PMAR. Statistical design was used, allowing for correlations of variables, at a significance level of p < 0.05. Results: Patients’ ages ranged from 1 month to 96 years (mean 35.05; SD ± 26.88). Adult patients (n = 1409; 65.41%) constituted the vast majority. The number of interventions to children below 1-year-old was noticeable (n = 394; 18.29%). Men were the most likely to suffer burns, up to three times more often than women (n = 1574, 73.07% vs. n = 570, 26.46%. T29—burns to multiple body areas (n = 890)—and T21—burns to the trunk (n = 255)—were most frequently reported as diagnoses according to the ICD-10 classification. A statistically significant association was found between age group and ICD-10 diagnosis (p < 0.001). The vast majority of patients were transported from the scene directly to Burn Treatment Centers (n = 1373; 63.74%). Treatment of pain by helicopter emergency medical services (HEMS) crews appeared to be effective (p < 0.001), and other interventions consisted of administering medications—ketamine (23.72%), rocuronium bromide (15.78%), propofol (14.02%)—and procedures such as sedation (30.87%), as well as intubation (13.42%) and mechanical ventilation (13.23%). Conclusions: The burn patient profile indicates men with a mean age of 35 years. Nevertheless, HEMS crews often carry out missions to infants and newborns. The most common diagnosis was extensive body burns. In 63.74% of the missions, patients were transported to the Burn Treatment Center. The HEMS crews implement effective pharmacological analgesia, and handle rescue medications and procedures to stabilize the patient’s condition.

Introduction Material and methods Results Conclusions

Introduction and Objective The subject of the article are the strategies used by nurses working in COVID-19 hospital units for coping with stress. The aim of the study was to make a comparative analysis between the styles, strategies and behaviours practiced by nurses working in COVID units and the nurses working in conservative treatment and surgical Materials and Method. For the study we used the Polish adaptation of Ch. S. Carver's standardized "Inventory for Measuring Coping with Stress Mini-COPE" (Brief-COPE), created by Z. Juczy & nacute;ski and N. Ogi & nacute;ska-Bulik. The research was carried out in 2021 on a group of 225 nurses working in different hospital units. Results. The results showed that in the COVID-19 units, avoidance and humor were used as coping strat-egies significantly more often than in the surgical and conservative treatments units. The observed strategies included planning, positive revaluation, use of psychoactive substances, preoccupation with other activities, denial, emotional discharge, and humor. Factors such as age, sex, marital status, education or place of residence turned out to have an influence on the ways of coping practiced by particular nurses. Conclusions. There is a clear distinction between the strategies, styles and behaviours observed among nurses working in COVID-19 units, and the ways of coping practiced by nurses working in non-COVID-19 units (conservative treatment and surgical). Nurses working in COVID-19 units were more likely to deny facts, distract themselves with different activities, or downplay the seriousness of the situation by joking and treating the situation with fun and humor, but also to use planning and positive reevaluation to cope with stress.

The aim of the report was to evaluate whether in utero exposure to paracetamol is associated with risk towards developing respiratory disorders such as asthma and wheeze after birth. MEDLINE (PubMed), EMBASE and Cochrane Library databases were searched for articles published in English to December 2021. The study involved 330,550 women. We then calculated the summary risk estimates and 95% CIs and plotted forest plots using random effect models (DerSimonian–Laird method) and fixed effect models. We also performed a systematic review of the chosen articles and a meta-analysis of studies based on the guidelines outlined in the PRISMA statement. Accordingly, maternal exposure to paracetamol during pregnancy was associated with a significant increased risk of asthma: crude OR = 1.34, 95% CI: 1.22 to 1.48, p < 0.001; and significant increased risk of wheeze: crude OR = 1.31, 95% CI: 1.12 to 1.54, p < 0.002. Results of our study confirmed that maternal paracetamol use in pregnancy is associated with an enhanced risk of asthma and wheezing in their children. We believe paracetamol should be used with caution by pregnant women, and at the lowest effective dose, and for the shortest duration. Long-term use or the use of high doses should be limited to the indications recommended by a physician and with the mother-to-be under constant supervision.

The aim of this study is to characterize the cognitive aspect of the semantic space of hope in patients in the terminal stage of cancer. This was confirmed in the research on hope by C. R. Snyder and B. Schrank. Hope is of great importance in all the great world religions and belief systems, both as regards a personal God or impersonal deities. Hoping is a human capacity with varying affective, cognitive and behavioral dimensions. Psychological, pedagogical (particularly in the framework of special needs pedagogy and thanatological pedagogy) and theological reflection on hope can provide support for dying people. In order to conduct the research, the semantic differential research method was selected. The research technique employed was a therapeutic conversation, and the research tool was the B.L. Block's DSN-3 test. The DSN-3 test allows one to assess hope in the semantic space in three aspects: cognitive, emotional and functional. For the purposes of this study, only the cognitive aspect was taken into account. The study was begun on 1 April 2010 and ended in the last days of December 2020. It included 110 male patients in the terminal stage of cancer. The youngest respondent was 19 years old and the oldest was 94 years old. The surveyed men most often perceived hope in the semantic space in the cognitive aspect as more true, wise, meaningful and real than false, stupid, meaningless and deceptive. Their attitude to hope was, therefore, more affirmative than negative. The research did not reveal the importance of the age of the respondents on the degree of affirmation/negation of hope in the cognitive aspect in the semantic space; however, men in the period of late maturity and professional activity expressed the lowest level of the affirmation of hope. It is worthwhile to conduct further research concerning hope in other aspects (especially emotional and functional) in the semantic space in order to use the obtained results to consider what to take into account when providing patients in the terminal stage of cancer with better personalized holistic care than before.

The increasing incidence of osteoporosis indicates that the disease is a serious public health problem, with about 200 million people being affected worldwide. The aims of this research are to assess the awareness and knowledge about osteoporosis in relation to risk factors, health condition, supplementation used, socio-demographic factors and other variables among osteoporosis patients. The study was conducted in 2016–2018 in osteoporosis clinics in Poland. The study involved 312 patients with a diagnosis of osteoporosis. In the diagnostic survey method, the authors’ own questionnaire was used. The results indicate that the more frequent the symptoms associated with the disease, the lower the general self-assessment of the health condition of the respondents (rho = −0.682, p < 0.001). In addition, almost half of the respondents stated that their knowledge of osteoporosis is negligible. Moreover, the use of dietary supplements significantly differentiated respondents in terms of health self-assessed (p < 0.001), and it is noteworthy that users of dietary supplements assessed their health significantly better. We also saw a statistically significant relationship between the self-assessment of knowledge about osteoporosis and the use of dietary supplements (p < 0.001). Accordingly, significantly more respondents rating their knowledge as good or very good used dietary supplements. The conducted study demonstrates the need to educate patients and implement educational programs at central and provincial levels to improve patient knowledge concerning the disease. Supporting adaptation to chronic diseases and appropriate therapeutic management may contribute to improved osteoporosis treatment and enhanced patient quality of life.

Background: Current vaccines against SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) and vaccine booster programs aim to reduce hospitalizations due to severe COVID-19 (coronavirus disease 2019). It is now accepted that vaccination does not completely prevent infection and that breakthrough COVID-19 does occur. This study included 53 vaccinated patients who were hospitalized at a single center in Poland with breakthrough COVID-19 and aimed to evaluate the factors associated with their clinical course.Material/Methods: This study covered the period 26 November 2021 to 11 March 2022. All patients had been vaccinated against COVID-19 with one of the following 4 vaccines: the mRNA-1273 (Moderna) mRNA vaccine (Spikevax); the BNT162b2 (Pfizer-BioNTech) mRNA vaccine (nucleoside-modified) (Comirnaty); the Ad26.COV2.S (Janssen/ J0ohnson & Johnson) recombinant vaccine (Jcovden); and the AZD1222 (ChAdOx1) (Oxford/AstraZeneca) recombinant vaccine (Vaxzevria).Results: The course of COVID-19 in vaccinated patients was relatively similar. The patients vaccinated more than 24 weeks earlier rarely needed a stay in the Intensive Care Unit (ICU) (P=0.021), and the occurrence of deaths was significantly lower in this group (P=0.046). Women remained in hospital considerably longer than men (P=0.011). Age and comorbidities did not affect the course of this infection.Conclusions: Despite the many advantages of the COVID-19 vaccination, our observations indicate a potential risk of infection after vaccination. The assessment of the course of COVID-19 in vaccinated patients gives the possibility to compare different vaccines and indicate factors that can reduce immunity.

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Virus-like particles (VLPs) modified through different molecular technologies are employed as delivery vehicles or platforms for heterologous antigen display. We have recently created a norovirus (NoV) VLP platform, where two influenza antigens, the extracellular domain of matrix protein M2 (M2e) or the stem domain of the major envelope glycoprotein hemagglutinin (HA2) are displayed on the surface of the NoV VLPs by SpyTag/SpyCatcher conjugation. To demonstrate the feasibility of the platform to deliver foreign antigens, this study examined potential interference of the conjugation with induction of antibodies against conjugated M2e peptide, HA2, and NoV VLP carrier. High antibody response was induced by HA2 but not M2e decorated VLPs. Furthermore, HA2-elicited antibodies did not neutralize the homologous influenza virus in vitro. Conjugated NoV VLPs retained intact receptor binding capacity and self-immunogenicity. The results demonstrate that NoV VLPs could be simultaneously used as a platform to deliver foreign antigens and a NoV vaccine.

Noroviruses (NoV) are the leading cause of epidemic acute gastroenteritis in humans worldwide. A safe and effective vaccine that prevents NoV infection or minimizes NoV disease burden is needed, especially for children and the elderly who are particularly susceptible to NoV disease. A plant-based expression system (magnICON (R)) was used to manufacture two different virus-like particle (VLP) immunogens derived from human NoV genogroups I and II, genotype 4 (GI.4 and GII.4), which were subsequently blended 1:1 (w/w) into a bivalent vaccine composition (rNV-2v). Here, we report on the safety and immunogenicity of rNV-2v from one pilot and two GLP-compliant toxicity studies in New Zealand White rabbits administered the vaccine subcutaneously (SC) or intramuscularly (IM). Strong genogroup-specific immune responses were induced by vaccination without adjuvant at various doses (200 to 400 mu g VLP/administration) and administration schedules (Days 1 and 7; or Days 1, 15 and 29). The results showed sporadic local irritation at the injection site, which resolved over time, and was non-adverse and consistent with expected reactogenicity. There were no signs of systemic toxicity related to vaccine administration relative to vehicle-treated controls with respect to clinical chemistry, haematology, organ weights, macroscopic examinations, or histopathology. In a 3-administration regimen (n + 1 the clinical regimen), the NOAEL for rNV-2v via the SC or IM route was initially determined to be 200 mu g. An improved GI.4 VLP variant mixed 1:1 (w/w) with the wild-type GII.4 VLP was subsequently evaluated via the IM route at a higher dose in the same 3-administration model, and the NOAEL was raised to 300 mu g. Serology performed in samples of both toxicity studies showed significant and substantial anti-VLP-specific antibody titers for rNV-2v vaccines administered via the IM or SC route, as well as relevant NoV blocking antibody responses. These results support initiation of clinical development of the plant-made NoV vaccine. (C) 2022 Published by Elsevier Ltd.

The SARS-CoV-2 virus caused a worldwide COVID-19 pandemic. So far, 6,120,834 confirmed cases of COVID-19 with 116,773 deaths have been reported in Poland. According to WHO, a total of 54,662,485 vaccine doses have been administered. New variants emerge that become dominant. The aim of this study was a comparison of antibody level after infection caused by Delta and Omicron variants. The study included 203 persons who underwent mild COVID-19 despite two doses of vaccine. The obtained results indicate that a significantly lower titer was observed in patients with the Omicron variant infection. Therefore, these patients may be at risk of reinfection with new strains of the Omicron variant. Due to the possibility of reinfection, booster vaccinations are necessary. Further epidemiological and clinical studies are necessary to develop new prevention strategies.

INTRODUCTION AND OBJECTIVE Epstein-Barr virus (EBV) is associated with cancers of the head and neck, including oropharyngeal cancer, which is increasing in incidence, and biomarker studies have potential in diagnostics and therapy. One of the most commonly deregulated microRNAs in cancers is miR-21-5p. It has been implicated in neoplastic transformation related to EBV infection in several investigations. The aim of this study was to determine the level of miR-21-5p in the serum of EBV (+) and EBV (-) oropharyngeal cancer patients. MATERIAL AND METHODS The study was carried out on 78 patients with confirmed OPSCC. Statistical analysis was used to investigate the relationship between clinical and demographic characteristics of patients. Enzyme immunoassays were used to determine the levels of miRNA, TLR9 and MMPs and cytokines. Statistical analysis was used to determine the relationship between miR21-5p and TLR9, MMP3, MMP9 levels, and the cytokines studied. RESULTS Significantly higher values of all tested parameters for miR-21-5p levels and grading as well as TN stage were found in the EBV (+) group. There was no statistically significant correlation between the miR-21-5p level and the levels of TNFα, VEGF, and TGFβ. Positive correlations were shown between miR-21-5p and IL-10, MMP-3 and -9. There was a negative correlation between the level of miR-21-5p and TLR9. CONCLUSIONS The present study showed that in EBV (+) patients the level of miR-21-5p in the serum was significantly higher than in EBV (-) patients. Our study results could influence future strategies for the diagnosis, prevention and treatment of oropharyngeal cancers.

The aim of this report was to determine the impact of flaxseed, soy and red clover, and their bioactive substances on the lipid profile in postmenopausal women in cardiovascular diseases prevention. We used the following databases: MEDLINE (PubMed), EMBASE and the Cochrane Library. Meta-analysis indicates that the intake of flaxseed by postmenopausal women is associated with a statistically significant reduction in total cholesterol (TC) levels (weighted-mean difference (WMD) = −0.26; 95% confidence interval (95% CI): −0.38 to −0.13; p = 0.0001), low-density lipoprotein cholesterol (LDL-C) levels (WMD = −0.19; 95% CI: −0.30 to −0.08; p = 0.0006), and high-density lipoprotein cholesterol (HDL-C) levels (WMD = −0.06; 95% CI: −0.11 to −0.01; p = 0.0150). The effect of soy protein on the lipid profile showed a significant decrease in TC levels: WMD = −0.15; 95% CI: −0.25–0.05; p = 0.0048, LDL-C levels: WMD = −0.15; 95% CI: −0.25–0.05; p = 0.0067, as well as a significant increase in HDL-C levels: WMD = 0.05; 95% CI: 0.02–0.08; p = 0.0034. Changes in the lipid profile showed a significant reduction in TC levels after the use of red clover (WMD = −0.11; 95% CI: −0.18–−0.04; p = 0.0017) and a significant increase in HDL-C levels (WMD = 0.04; 95% CI: 0.01 to 0.07; p = 0.0165). This meta-analysis provides evidence that consuming flaxseed, soy and red clover can have a beneficial effect on lipids in postmenopausal women and suggest a favorable effect in preventing cardiovascular diseases.