Mariusz Goniewicz

Current genetic methodologies in the identification of disaster victims and in forensic analysis

This review presents the basic problems and currently available molecular techniques used for genetic profiling in disaster victim identification (DVI). The environmental conditions of a mass disaster often result in severe fragmentation, decomposition and intermixing of the remains of victims. In such cases, traditional identification based on the anthropological and physical characteristics of the victims is frequently inconclusive. This is the reason why DNA profiling became the gold standard for victim identification in mass-casualty incidents (MCIs) or any forensic cases where human remains are highly fragmented and/or degraded beyond recognition. The review provides general information about the sources of genetic material for DNA profiling, the genetic markers routinely used during genetic profiling (STR markers, mtDNA and single-nucleotide polymorphisms [SNP]) and the basic statistical approaches used in DNA-based disaster victim identification. Automated technological platforms that allow the simultaneous analysis of a multitude of genetic markers used in genetic identification (oligonucleotide microarray techniques and next-generation sequencing) are also presented. Forensic and population databases containing information on human variability, routinely used for statistical analyses, are discussed. The final part of this review is focused on recent developments, which offer particularly promising tools for forensic applications (mRNA analysis, transcriptome variation in individuals/populations and genetic profiling of specific cells separated from mixtures).

The role of Chromium III in the organism and its possible use in diabetes and obesity treatment.

INTRODUCTION Diabetes and obesity are diseases characterized by their increasing incidence every year. When comparing with healthy subjects, the serum levels of chromium (Cr) are lowered in these two diseases. Several studies conducted in laboratory animals with experimentally- induced diabetes demonstrated that supplementation with chromium ions (III) decreased glucose concentration in the blood, reduced the probability of atherosclerosis and heart attack, lowered the levels of cholesterol and low density lipoprotein (LDL). The Importance of chromium is actually challenged due to lack of clear manifestations of Cr deficiency in humans and animals. OBJECTIVE The aim of this review was to present current knowledge about Cr its role in the organism and possible mechanisms of its action also in metabolic disorders such as diabetes or obesity. STATE OF KNOWLEDGE In the last decade, Cr was established to be rather a beneficial than essential trace element in mammals, and has gained popularity as a nutritional supplement and a component of many multivitamin/mineral formulations, fortified food and energy drinks. Cr supplements are widespread for diabetes and obesity treatment, despite conflicting reports on its efficacy. It was suggested that Cr shows a beneficial influence upon glucose and lipid disturbances. CONCLUSIONS The recent clinical trials provided evidence both in favor and against the importance of Cr in healthy and ill organisms. Unfortunately, also the molecular mechanism by which chromium affects glucose and lipid metabolism is still unclear. Beneficial effects of diet supplementation with different sources of Cr³⁺ can be potentially explained by rather pharmacological than nutritional effects.

Population biobanking in selected European countries and proposed model for a Polish national DNA bank

Population biobanks offer new opportunities for public health, are rudimentary for the development of its new branch called Public Health Genomics, and are important for translational research. This article presents organizational models of population biobanks in selected European countries. Review of bibliography and websites of European population biobanks (UK, Spain, Estonia). Some countries establish national genomic biobanks (DNA banks) in order to conduct research on new methods of prevention, diagnosis and treatment of the genetic and lifestyle diseases and on pharmacogenetic research. Individual countries have developed different organizational models of these institutions and specific legal regulations regarding various ways of obtaining genetic data from the inhabitants, donors’ rights, organizational and legal aspects. Population biobanks in European countries were funded in different manners. In light of these solutions, the authors discuss prospects of establishing a Polish national genomic biobank for research purpose. They propose the creation of such an institution based on the existing network of blood-donation centres and clinical biobanks in Poland.

Road accident rates: strategies and programmes for improving road traffic safety

IntroductionNowadays, the problem of road accident rates is one of the most important health and social policy issues concerning the countries in all continents. Each year, nearly 1.3 million people worldwide lose their life on roads, and 20–50 million sustain severe injuries, the majority of which require long-term treatment.DiscussionThe objective of the study was to identify the most frequent, constantly occurring causes of road accidents, as well as outline actions constituting a basis for the strategies and programmes aiming at improving traffic safety on local and global levels. Comparative analysis of literature concerning road safety was performed, confirming that although road accidents had a varied and frequently complex background, their causes have changed only to a small degree over the years. The causes include: lack of control and enforcement concerning implementation of traffic regulation (primarily driving at excessive speed, driving under the influence of alcohol, and not respecting the rights of other road users (mainly pedestrians and cyclists), lack of appropriate infrastructure and unroadworthy vehicles.ConclusionsThe number of fatal accidents and severe injuries, resulting from road accidents, may be reduced through applying an integrated approach to safety on roads. The strategies and programmes for improving road traffic should include the following measures: reducing the risk of exposure to an accident, prevention of accidents, reduction in bodily injuries sustained in accidents, and reduction of the effects of injuries by improvement of post-accident medical care.

DNR declaration — emergency medical system nurses’ opinions

Advance directive and other declarations of will made by patients in a case of mental illness still raise ethical and legal issues. In Poland there is no legal regulation, neither research about code of conduct in situation of do not attempt resuscitation. There are also not enough studies regarding Healthcare workers’ opinion about DNAR declaration (Do Not Attempt Resuscitation). The study is aimed at finding out emergency medical system nurses opinion on the subject of enforcing do not attempt resuscitation in situation of circulatory and respiratory arrest. Methods: The research was conducted by means of the diagnostic survey method applying a self — constructed questionnaire. The study was carried out among 82 (100%) nurses, from September to December 2011. Obtained information were analyzed statistically, Chi-square of independence with assumed p ≤ 0.05. level of significance was used for statistical analysis. Results: The study of the respondents’ opinion shows that 67% Healthcare employees think that DNAR declaration should be obligatory in Poland. Contrary opinion has 7.3% of respondents. In their opinion the decision to refrain from resuscitating should be made by attending physician − 46.3% and medical board − 29.3%. Information enclosed within DNAR declaration, in most of respondents’ opinion − 59.5%, should be only passed on in written form. Conclusions: Majority of respondents agree that patients have a right to refrain from resuscitating as a self − determination act. Respondents concur the introduction of DNAR declaration in Polish Healthcare system. In respondents’ opinion that decision should be required in written form and an attending physician should decide about its implementation, what violates the existing rule. The execution of living will declaration raises ethical issues. Additionally, it also appears as public/social problem. The last stage of incurable disease is given as justifiable circumstances of DNAR.

PW 0208 Road traffic injuries in poland: magnitude and risk factors

The article presents the epidemiology of road crashes in Poland in the years 2004–2014. The research is based on the analysis of data contained in the reports of the Prevention and Analysis Office of Road Traffic Headquarters of Police; National Road Safety Program– GAMBIT 2005, National Road Safety Program 2013 to 2020; and Strategy for Efficient State in 2020, plus previous publications describing road safety in Poland. Our results suggest several thousand people are killed on Polish roads annually, and tens of thousands are injured. Road crashes represent the leading cause of death for Polish men up to 44 years of age. The most common causes of road crashes in Poland include failure to comply with the rules of the road traffic (mainly excessive speed, intoxication while engaged in traffic, and lack of respect for the rights of other road users, especially disregard for the rights of pedestrians and cyclists), and low driving skills. We also found drivers poorly assessed road situations, possessed a lack of adequate road infrastructure, and maintained many vehicles in poor condition. Drivers caused the majority of MVA in Poland in years 2004 to 2014. The most common underlying causes were inappropriate speed given the road traffic conditions and not respecting the right-of-way concerning other road users. Despite various measures that are being taken to improve safety on Polish roads, the number of the dead and wounded as a result of road crashes is still very high. It is necessary to continue multifaceted actions to improve safety on the roads in Poland.

Children road traffic injuries in Poland

Abstract Road traffic injuries are the leading cause of child mortality in Poland, resulting in more deaths than cancer or birth defects. We present the main problems of road safety and the nature of the causes and consequences of accidents among children based on the World Health Organization Report. Children injuries are one of the main problems in modern medicine requiring vigorous and preventive actions. Children of all ages should be intensively involved in the educational activities related to road safety. Raising awareness concerning the risks associated with children’s participation in traffic as well as the awareness of parents and carers can greatly reduce the number of accidents.

Analysis of the effectiveness concerning initiatives for pedestrians’ safety on roads: a questionnaire survey

Abstract Introduction. One of the most important issues and challenges of public safety policy in highly developed countries is the problem of ensuring road safety, along with dealing with health and material losses resulted from accidents. Unfortunately, Poland, in comparison to other EU countries, has one of the worst statistics regarding accidents and mortality ratios, therefore it is essential to undertake long-term actions aimed at improving road safety, as well as educating drivers and pedestrians. Aim. The purpose of this study is to analyse the problem and to investigate whether traffic safety campaigns are effective, and if they reach young audience. Material and methods. The research was conducted in the first quarter of 2018 among the students of Faculty of Health Sciences of the Medical University of Lublin. The study method applied was a diagnostic survey, and the tool was an original questionnaire. The participation was voluntary and anonymous. The obtained results were the subject of later statistical analysis. As many as 153 young respondents aged between 18 and 25 were tested, out of whom 73.68% were women and 26.32% were men. Results. Over half of the surveyed (56.3%) declared walking as the main form of participation in traffic, and 25.9% of the surveyed used public transport. The most numerous group of the examined (34.21%) thought that the Polish roads were rather unsafe. As the reasons for the low safety on the Polish roads the respondents identified: bad condition of the roads (69.1%), drivers’ recklessness (67.1%), and maladjustment of the driving style to weather conditions (60.5%). All respondents have encountered campaigns concerning road safety, however not too often (56.58% less than once a month). The surveyed encountered these social campaigns on TV (88.2%), on the Internet (54.6%), and on billboards (23.7%). Conclusion. Promotional campaigns concerning road safety have a greater impact on women. In the examined group, around 67% of women changed their behaviour as a result of the campaigns, and only 42.5% of men. Social campaign which was best remembered, and had the biggest influence on the respondents (50.3%) was „Say STOP to reckless driver you love”.

Comparison of two treatment methods of congenital clubfoot in the orthopaedists’ opinion

Abstract Introduction. Clubfoot is the second most common birth defect of the lower limb. In Europe (including Poland) it concerns about 1-2 in 1000 newborns. What is characteristic for a clubfoot, is change in the foot shape and its impairment with preserving anatomical structures. Aim. The aim of this work is to gather opinions of orthopedic physicians on the effectiveness of the two methods used to treat congenital clubfoot: the Turco method and the Ponseti method. Material and methods. The research method used in the work was a diagnostic survey and research technique was the author’s questionnaire designed to gather opinions of orthopedic surgeons on the two methods of clubfoot treatment. The questionnaires were collected in the Orthopaedic Clinics in Lublin and Rzeszów, as well as during the specialization courses for orthopaedic surgeons in Lublin. Results. The most important advantages of the Ponseti method according to respondents are high clinical effectiveness (average 4.48) and short duration of hospitalization (average 4.31). While the most important disadvantages of the method is length of rehabilitation (average 2.85) and convalescence (average 2.36). Top assets of the Turco method in turn, according to respondents, are high clinical efficiency (average 2.92) and certainty of the patient’s recovery (2.74). In turn, the downsides of the Turco method according to the respondents are high invasiveness (average 4.11) and length of convalescence (average 3.87). Conclusion. The Ponseti method is the surveyed doctors’ preferred method of congenital clubfoot treatment.

Public awareness about the use of automatic external defibrillator (AED) in giving first aid

Abstract Introduction. Chances for survival of a patient who has suffered from sudden cardiac arrest (SCA) depend on a number of factors. One of the most important however, is the time within which the patient is provided with actions to restore normal heart function. In the Guidelines for Resuscitation 2015, The European Resuscitation Council states that defibrillation done within 3-5 minutes since a patient with SCA lost his/her consciousness can increase the survival rate up to 50-70%. However, such a short time of providing help is only achievable through the implementation of universal defibrillation programs and the automatic external defibrillator (AED) devices densely distributed in public places. By contrast, every minute of delay in defibrillation reduces the probability of survival by approximately 10-12% until the hospital discharge. Aim. The purpose of the research was to elicit the opinions of adult respondents on first aid and the use of automatic external defibrillator (AED). Material and methods. The research method used in this paper was a diagnostic survey, the technique was a web-based questionnaire, and a research tool was the authors’ own questionnaire survey. The survey was active between April 8, 2016 and May 20, 2016. During this time, 116 opinions were collected. Results. As many as 77% of respondents declared that they had attended a first aid course, but 21% of them stated that they no longer remembered the knowledge acquired. The number of 63% of respondents did not know what an automatic external defibrillator is. Only 27% of respondents knew that AEDs are public devices, and only 47% believed that using an AED would not worsen the health of the victim. Conclusions. The availability of AEDs and knowledge of their use are insufficient. Low social awareness and irrational fear of using an AED (fear of deterioration of the victim’s health) support the need for continuing education in this area.