Bartłomiej Drop

Effect of G(-174)C polymorphism in interleukin-6 gene on cardiovascular disease in type 2 diabetes patients

Interleukin-6 (IL-6) is an important pro-inflammatory cytokine of relevance to cardiovascular diseases. The aim of this case-control study was to evaluate the association between the G(-174)C functional polymorphism in the IL-6 gene and risk of cardiovascular disease (CVD) in type 2 diabetes patients. We examined 1090 patients with T2DM and 612 controls. All subjects were genotyped for the G(-174)C polymorphism by polymerase chain reaction (PCR) and restriction analysis. There were no significant differences in the distribution of genotypes and alleles between T2DM patients and healthy controls. Significantly higher C allele frequency was observed in CVD+ patients compared to CVD- subgroup (53% vs. 32%, p<0.0001). The odds ratio for C allele was 2.4 (95% CI 1.99-2.9, p<0.0001) and for CC genotype 4.55 (95% CI 3.12-6.63, p<0.000). When the distribution of G(-174)C polymorphism was compared in subgroups with different clinical phenotypes of CVD, a significant association of CC genotype with myocardial infarction was observed. Forty eight percent of patients with MI had the CC genotype compared to 22% of patients without MI (p<0.0001). In conclusion, type 2 diabetes patients carrying the C allele of the IL-6 G(-174)C polymorphism have a significantly increased risk of CVD.

Coinfection with Epstein–Barr Virus (EBV), Human Papilloma Virus (HPV) and Polyoma BK Virus (BKPyV) in Laryngeal, Oropharyngeal and Oral Cavity Cancer

Most research providing evidence for the role of oncogenic viruses in head and neck squamous cell carcinoma (SCC) development is focused on one type of virus without analyzing possible interactions between two or more types of viruses. The aim of this study was to analyse the prevalence of co-infection with human papillomavirus (HPV), Epstein–Barr virus (EBV) and polyoma BK virus (BKPyV) in oral, oropharyngeal and laryngeal squamous cell carcinomas in Polish patients. The correlations between viral infection, SCC, demographic parameters, evidence of metastases and grading were also investigated. Fresh-frozen tumour tissue samples were collected from 146 patients with laryngeal, oropharyngeal and oral cancer. After DNA extraction, the DNA of the studied viruses was detected using polymerase chain rection (PCR) assay. Males (87.7%) with a history of smoking (70.6%) and alcohol abuse (59.6%) prevailed in the studied group. Histological type G2 was recognized in 64.4% cases. The patients were most frequently diagnosed with T2 stage (36.3%) and with N1 stage (45.8%). Infection with at least two viruses was detected in 56.2% of patients. In this group, co-infection with HPV/EBV was identified in 34.1% of cases, EBV/BKV in 23.2%, HPV/BKV in 22.0%, and HPV/EBV/BKV in 20.7%. No difference of multiple infection in different locations of cancer was observed. The prevalence of poorly differentiated tumours (G3) was more frequent in co-infection with all three viruses than EBV or BKV alone. A significant correlation was observed between tumour dimensions (T) and lymph-node involvement (N) in co-infected patients compared to single infection. Further studies are necessary to clarify whether co-infection plays an important role in the initiation and/or progression of oncogenic transformation of oral, oropharyngeal and laryngeal epithelial cells.

Ivabradine attenuates the anticonvulsant potency of lamotrigine, but not that of lacosamide, pregabalin and topiramate in the tonic-clonic seizure model in mice

Hyperpolarization-activated cyclic nucleotide-gated (HCN) channels are involved not only in synaptic transmission and neuronal excitability under physiological conditions, but also in seizure activity. To determine the influence of ivabradine (an HCN channel inhibitor) on the anticonvulsant potency of four novel antiepileptic drugs (AEDs: lacosamide, lamotrigine, pregabalin and topiramate) in the mouse maximal electroshock-induced seizure (MES) model. Adult male albino Swiss mice were challenged with maximal electroconvulsions (electric current of 25mA delivered via auricular electrodes). Total brain concentrations of AEDs were measured with high-pressure liquid chromatography. Ivabradine (10mg/kg, i.p.) significantly reduced the anticonvulsant potency of lamotrigine by elevating the ED50 value of the AED from 7.48 (6.15-9.11) to 10.07 (8.85-11.45) mg/kg (P<0.05) in the mouse MES model. In contrast, ivabradine (10mg/kg, i.p.) did not significantly affect the anticonvulsant potency of lacosamide, pregabalin or topiramate in the mouse MES model. Additionally, ivabradine had no impact on total brain concentrations of all the studied AEDs in mice. A special caution is advised when combining ivabradine with lamotrigine in epilepsy patients due to the possible pharmacodynamic reduction of the anticonvulsant action of the later drug. The combinations of ivabradine with lacosamide, pregabalin and topiramate seem to be pharmacodynamic and neutral from a preclinical viewpoint.

Nursing care quality and post-operative wound infections

Abstract Introduction. The aim of the surveillance over infections is to define the critical points, lacks in knowledge of staff skills, as well as lack of equipment. It is aimed at preventing the same mistakes from being conducted all over again, instead of making those guilty suffer from consequences of their mistakes. Aim. The authors aimed at assessing the quality of nursing care procedures in terms of preventing post-operative wound infections. Materials and methods. The research was conducted in medical treatment, surgical and intensive care ward. A self-constructed questionnaire “Nursing care quality and prophylaxis of hospital-acquired infections” was used for the study. It was validated using the peer judges method. Results and conclusions. The highest nursing care coefficient was noted in county hospitals ( x̅ = 94.5%), while the lowest was noted in clinical hospitals ( x̅ = 91.3%). It was concluded that there is a deficit in adherence to procedures related to post-operative wound treatment.

The role of long term care centers in the Polish system of mental health care

Abstract Objective: The aim of this work is to review the role of mental health care center and treatment center specialized in psychiatry in the Polish system of mental health care as a whole. Review: For many years in Poland, the process of transformation of psychiatric care model from the institutional (inpatient setting, most expensive) to community care model (personalized, much cheaper), has been taking place. The effective - coordinated system of community care should significantly improve cooperation in the treatment, while the community forms of health care should ensure full availability, complexity, and continuity of care provision. In many cases, the community support is inadequate and cannot provide patient with care at his home environment. For mentally ill, there may be a need for the use of the long term health care centers specialized in psychiatry. Conclusions: A long term mental health care center specialised in mental health plays an important role in long-term care for the mentally ill. As far as a mental health service user’s perspective is concerned, the continuity of care and treatment in the long term health care center (as a health care unit) appears to be more useful and satisfying compared to a residential home for people with chronic mental illnesses. There is a need for broad discussion on the special place of the long term health care center specialized in psychiatry in the present Polish system of mental health care and on the improving of care pathways between inpatient-, day care-and, community care package.

Community system of social support

Abstract Community System of Social Support is the basis of modern health care systems not only in Poland but all over the world in the prophylaxis-treatment-rehabilitation procedure. In Poland, family doctors, commune councils and territorial self-governments are involved in it. Family doctors perform a substantial function, whereas commune councils and territorial self-governments an administrative one. The principle of the system work is evaluation of its benefits. Its aim is the reduction of the number of patients who abuse alcohol and those who abuse alcohol despite treatment.

Serum EBV antibodies and LMP-1 in Polish patients with oropharyngeal and laryngeal cancer

BackgroundThe association between Epstein-Barr virus (EBV) and the development of head and neck cancer was reported by many researchers. The aim of the present study was to detect EBV DNA and EBV antibodies in 110 Polish patients with oropharyngeal and laryngeal cancer compared to 40 healthy individuals.MethodsFrozen tumor tissue fragments were tested using nested PCR assay for EBV DNA detection. Sera from all individuals were investigated using ELISA tests to detect the presence of VCA IgM and IgG, EBNA IgG, EA IgG.ResultsEBV DNA was detected in 52.7% of the patients (25% in controls). EBVCA were detected in 94.5%, EBNA in 96.4% and EA in 94.5% of patients. The significantly higher level of EA in the patients suggests EBV reactivation. The majority of patients (83%) were infected with wild-type EBV.ConclusionOur study showed that this variant seems to be associated with oropharyngeal and laryngeal cancer in the Polish population.

Injuries treated in hospital among urban and rural inhabitants of eastern Poland

INTRODUCTION AND OBJECTIVE Injuries are a serious medical and social problem, especially when accompanied by distant or deferred effects, often causing serious dysfunctions and permanent disability for life. The study aimed at presenting the incidence of injuries of urban and rural population treated in a district hospital in eastern Poland. MATERIAL AND METHODS The study was carried out in the Independent Public Health Care Institution in Kraśnik in 2011 among patients hospitalized in the Department of Trauma Surgery and Orthopedic Unit who sustained injuries. Medical records of 795 patients - 326 women and 469 men, aged 10-99 years, were analyzed. RESULTS During the period considered among those hospitalized due to injuries, men (59%), those aged 50-59 years (19.0%), and living in rural areas (72.7%) predominated. Injuries most commonly affected the head (18.87%), elbow and forearm (16.86%), knee and lower leg (16.60%), and the hip and thigh (13.96%). Average hospital stay was 5.65 days and was the longest for hip and thigh injuries (11.86 days). CONCLUSIONS Injuries occurred most frequently in the population of patients living in rural areas, often among men, usually on weekdays and in the morning.

International strategies in the face of aging population

Abstract Introduction. Population aging poses many important economic, social, and health challenges to the modern world. This applies mostly to developed countries. The phenomenon requires joint action of Member States of the European Union, the World Health Organization, the United Nations, the Council of Europe as well as some unified strategies for the actions taken by these entities. Aim. The aim of this study was to demonstrate international strategies implemented in the face of demographic changes. Material and methods. The authors analyzed the documents outlining strategies for both organizations and entities, as well as recommendations for international scientific consultation on strategy of the aging population. Results. Analysis of changes happening to the oldest age groups showed the need for cooperation between countries. An overview of the strategies being taken at the moment and those that had been undertaken previously by international entities can contribute to modify the arrangements of the elderly; in order to improve the living conditions in multidimensional aspect. Conclusions. The key to achieving the desired effect through implementing the policies of individual countries is to monitor them on a regular basis.

A comparison of the levels of satisfaction with the medical services provided by primary healthcare centers in selected communes in Lubelskie Voivodeship

Abstract Introduction. Family medicine remains the primary type of medical services in Poland and it is supposed to treat both individual patients and the society as a whole. Due to the growing commercialization of the health service, most primary healthcare centers have transformed into non-public healthcare facilities. The public ones (called SPZOZ in Polish) account only for a small fraction of the whole number of primary healthcare facilities. The quality of medical services provided by such facilities, as patients see it, remains one of the key elements determining the development of family medicine centers. Aim. The aim of this paper was to assess patient satisfaction levels regarding the healthcare services they received in two primary healthcare institutions, both of the NZOZ and SPZOZ type, in a small town located close to Lublin. Material and methods. An anonymous survey was filled out by 30 patients of both a public and non-public healthcare center located in Niemce (Niemce Commune, Lublin District). The quality of services was assessed using an original questionnaire in the form of a poll. Results. The results obtained indicate a clear relationship between one’s trust to the physician, diagnosis accuracy and visiting the particular center again, in order to continue the treatment. For older subjects, it was nurses’ kindness and politeness that was the most important. The elderly appreciated the kindness and politeness of the nurses in particular. No significant differences were found between the institutions in respect of the overall perception of satisfaction with services. In terms of infrastructure assessment, the majority of positive feedback was provided for NZOZ. Conclusions. The findings above suggest that it is essential to conduct surveys on a regular basis, in order to check patients’ assessment of the service quality in various institutons.