Qualifications, competencies and professional liability of palliative care nurses

The right qualifications and competencies are needed to practice a particular profession. These terms are often used interchangeably, as there is considerable overlap between the scopes of the two concepts. Nowadays, competencies are increasingly expressed in terms of emphasising autonomy and responsibility in the performance of tasks. The practice of nursing consists in the provision of health services by a person who is qualified and licensed to practise the profession. In Poland, a nurse achieves the professional qualification after graduating from a nursing school. During the course of his/her career, the nurse may enhance the knowledge and skills necessary to provide health services through various forms of postgraduate education. Nursing is an autonomous profession, regulated by law. Completion of the various forms of postgraduate training provides nurses with additional qualifications that are worth bearing in mind in their daily professional work.The right qualifications and competencies are needed to practice a particular profession. These terms are often used interchangeably, as there is considerable overlap between the scopes of the two concepts. Nowadays, competencies are increasingly expressed in terms of emphasising autonomy and responsibility in the performance of tasks. The practice of nursing consists in the provision of health services by a person who is qualified and licensed to practise the profession. In Poland, a nurse achieves the professional qualification after graduating from a nursing school. During the course of his/her career, the nurse may enhance the knowledge and skills necessary to provide health services through various forms of postgraduate education. Nursing is an autonomous profession, regulated by law. Completion of the various forms of postgraduate training provides nurses with additional qualifications that are worth bearing in mind in their daily professional work

Adipokines and Insulin Resistance in Young Adult Survivors of Childhood Cancer

We examined the association between adipokines (leptin, adiponectin, and resistin), radiotherapy, measurement of body fat, and insulin resistance among young adult survivors of childhood cancer (CCS). Materials and Methods. Seventy-six survivors were included (mean age 24.1±3.5 years). Insulin resistance (IR) was calculated using the homeostasis model assessment (HOMA-IR). The serum levels of adipokines were assayed by immunoassays. Fat mass was evaluated by DXA. Results. Mean adiponectin level and mean body FAT were higher in the examined females than in males (10009±6367 ng/mL versus 6433±4136 ng/mL, p<0.01; 35.98±9.61% versus 22.7±7.46%, p<0.001). Among CCS, one of 75 patients met the criteria of insulin resistance, and in 14 patients there was impaired fasting glucose. The multiple regression model for females showed that leptin/adiponectin ratio (LA ratio) significantly affected HOMA-IR (increase of 0.024 per each unit of LA ratio; p<0.05). Radiotherapy had no effect on serum adipokines and IR. Conclusion. The observed results support the hypothesis that adiponectin might be associated with insulin resistance and it can not be ruled out that changes in the mean level of adiponectin per FAT mass or leptin/adiponectin ratio may precede the occurrence of insulin resistance in the future

Are multiple short-time general anesthesia in children safe procedures?

Wstęp. Dzieci leczone z powodu chorób nowotworowych często przed zabiegami diagnostycznymi i leczniczymi otrzymują krótkotrwałe znieczulenie ogólne. Do powikłań, które mogą wystąpić po znieczuleniu ogólnym możemy zaliczyć, między innymi, powikłania ze strony układu oddechowego, powikłania ze strony układu krążenia, zaburzenia psychiczne, ból, nudności i wymioty. Cel pracy. Celem pracy była analiza rodzaju i częstości występowania powikłań w trakcie i po zastosowaniu krótkotrwałego znieczulenia u dzieci leczonych z powodu chorób nowotworowych, z uwzględnieniem wieku, płci, stanu ogólnego &#8212; według American Society of Anaesthesiology (ASA), i rodzaju zastosowanego preparatu do znieczulenia. Materiał i metody. Badania przeprowadzono w Klinice Onkologii i Hematologii Dziecięcej Uniwersyteckiego Dziecięcego Szpitala Klinicznego, w grupie 29 pacjentów, 17 dziewcząt i 12 chłopców, u których łącznie wykonano 136 zabiegów w znieczuleniu ogólnym. W grupie dziewcząt wykonano 69 znieczuleń, chłopców &#8212; 67. Wyniki. Wśród badanych dzieci w wieku poniżej 5 lat było 18 osób, 8 pacjentów było w wieku 5&#8211;10 lat, 3 przekroczyło 10. rok życia; 26 pacjentów otrzymało znieczulenie w celu wykonania badań diagnostycznych. Trzech pacjentów poddano znieczuleniu przed radioterapią. Pacjentów zakwalifikowano do znieczulenia po dokonaniu wcześniejszej oceny w skali ASA. Podczas 136 znieczuleń zaobserwowano łącznie 20 powikłań (14,7%), w tym: uczulenia (7/20 &#8212; co stanowiło 35% wszystkich powikłań), zaburzenia oddychania (wystąpiły w 6/20 przypadkach, stanowiąc tym samym 30% wszystkich powikłań), wymioty (pojawiły się 4 razy i stanowiły 20% powikłań). Natomiast zaburzenia pod postacią agresji, pobudzenia, halucynacji zaobserwowano po 3 znieczuleniach i stanowiły 15% wszystkich powikłań. W grupie pacjentów poniżej 5. roku życia w 14 przypadkach na 104 znieczulenia zaobserwowano powikłania, głównie pod postacią zaburzeń oddychania. Dzieci w wieku 5&#8211;10 lat poddano w sumie 22 znieczuleniom, po których w 3 przypadkach pojawiły się działania niepożądane, głównie objawy alergiczne. Natomiast dzieci powyżej 10. roku życia znieczulono ogółem 10 razy. Podczas znieczuleń powikłania pojawiły się w 3 przypadkach. W badanej grupie wszyscy pacjenci otrzymywali znieczulenie kilkakrotnie. Wnioski. Krótkotrwałe znieczulenia ogólne stosowane do zabiegów diagnostyczno-terapeutycznych u dzieci są bezpieczne, a obserwowane w nielicznych przypadkach działania niepożądane mają charakter krótkotrwały i nie zagrażają życiu.Introduction. Children treated for cancer often require diagnostic and therapeutic procedures conducted in short-term general anesthesia. Complications that may occur after general anesthesia include among others: side effects from respiratory or cardiovascular systems, mental disorders, pain, nausea and vomiting. Aim of the study. The aim of the study was analysis of type and frequency of side effects during and after short-time general anesthesia in children treated for malignancies. Age, general condition according to American Society of Anaesthesiology (ASA) and type of anesthetic drug were taken into consideration. Materials and methods. The study group consisted of 29 patients (17 girls and 12 boys) treated at the Department of Pediatric Oncology and Hematology, Children&#8217;s Teaching Hospital in Bialystok. In this group 136 times general anesthesia was performed (69 in girls and 67 in boys). Results. Among studied patients 18 were younger than 5 years old, 8 were in between 5&#8211;10 years old and 3 were older than 10. 26 patients had general anesthesia to perform diagnostic procedures. In 3 children general anesthesia was used before radiotherapy. Patients were qualified to the general anesthesia after assessment according ASA. During 136 procedures 20 (14,7%) side effects were observed. Allergy symptoms were observed in 7/20 cases (35% of all side effects), problems with respiration were observed in 6/20 patients (30% of all side effects) and vomiting was present in 4/20 children (20% of all side effects). Aggressive behavior, hyperactivity and hallucinations were observed after 3 procedures (15% of all side effects). In patients younger than 5 years old, in 14 out of 104 cases the side effects were observed, mainly the respiratory problems. In children between 5 and 10 years old, 22 procedures were carried out, in which 3 side effects were observed, mainly allergic symptoms. Children older than 10 had 10 procedures and 3 side effects during general anesthesia. In the studied group all patients were anesthetized multiple times. Conclusions. Short- time general anesthesia used for diagnostic and therapeutic reasons in children are safe procedures. Observed side effects are rare, of short duration and are not life-threatening

Double trouble combat grenade allergic contact dermatitis

Allergic contact dermatitis (ACD) is a frequent inflammatory and the most common type of occupational skin disease. Chloroacetophenone(CN) has been one of the most typical riot control agents known since the end of the First World War. It is used by the armed andpolice forces and as pocket tear gas for personal protection. However, it is considered to be safe and, therefore, should not cause fatalhealth effects. Although CN is stated to provoke ACD, there are only a few cases found in the literature similar to the one shown below

AdipoRon, an Orally Active, Synthetic Agonist of AdipoR1 and AdipoR2 Receptors Has Gastroprotective Effect in Experimentally Induced Gastric Ulcers in Mice

Introduction: Adiponectin is a hormone secreted by adipocytes, which exhibits insulin-sensitizing and anti-inflammatory properties and acts through adiponectin receptors: AdipoR1 and AdipoR2. The aim of the study was to evaluate whether activation of adiponectin receptors AdipoR1 and AdipoR2 with an orally active agonist AdipoRon has gastroprotective effect and to investigate the possible underlying mechanism. Methods: We used two well-established mouse models of gastric ulcer (GU) induced by oral administration of EtOH (80% solution in water) or diclofenac (30 mg/kg, p.o.). Gastroprotective effect of AdipoRon (dose 5 and 50 mg /kg p.o) was compared to omeprazole (20 mg/kg p.o.) or 5% DMSO solution (control). Clinical parameters of gastroprotection were assessed using macroscopic (gastric lesion area) and microscopic (evaluation of the gastric mucosa damage) scoring. To establish the molecular mechanism, we measured: myeloperoxidase (MPO), superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPX) activities; glutathione (GSH) level; and IL-1β, adenosine monophosphate-activated protein kinase (AMPK), and phosphorylated AMPK expression in gastric tissue. Results: AdipoRon produced a gastroprotective effect in both GU mouse models as evidenced by significantly lower macroscopic and microscopic damage scores. AdipoRon exhibited anti-inflammatory effect by reduction in MPO activity and IL-1β expression in the gastric tissue. Moreover, AdipoRon induced antioxidative action, as demonstrated with higher GSH levels, and increased SOD and GPX activity. Conclusions: Activation of AdipoR1 and AdipoR2 using AdipoRon reduced gastric lesions and enhanced cell response to oxidative stress. Our data suggest that AdipoR1 and AdipoR2 activation may be an attractive therapeutic strategy to inhibit development of gastric ulcers

Collected novels

Edycja opowiadań Gustawa Herlinga-Grudzińskiego zawierająca opracowanie krytyczne.Critcial edition of Gustaw Herling-Grudziński's novels

Expression of FFAR3 and FFAR4 Is Increased in Gastroesophageal Reflux Disease

Background: The negative impact of a high-fat diet on the course of gastroesophageal reflux disease (GERD) has been previously reported. Free fatty acid receptors (FFARs) may be mediators of this phenomenon. The aim of this study was to characterize the role of FFARs in the course of nonerosive (NERD) and erosive (ERD) reflux disease. Methods: Collectively, 73 patients (62 with GERD and 11 healthy controls (HCs)) were recruited to the study. Esophageal biopsies were drawn from the lower third of the esophagus and kept for further experiments. Quantitative, real-time polymerase chain reaction was used to assess the expression of FFAR1, FFAR2, FFAR3, and FFAR4 in biopsies. Histological evaluation of dilated intracellular spaces (DISs) was also performed. Results: FFAR3 exhibited the highest expression, and FFAR4 exhibited the lowest expression in all esophageal samples. Higher relative expression of FFAR1 and FFAR2 and significantly higher expression of FFAR3 (p = 0.04) was noted in patients with GERD compared to respective HCs. Patients with nonerosive GERD (NERD) presented higher expression of all FFARs compared to patients with erosive GERD (ERD) and respective HCs. Interestingly, in patients with ERD, the expression of FFAR3 was lower than in HCs. Significant, weak, positive correlation was found for FFAR3 and FFAR4 expression and DIS scores (r = 0.36, p &lt; 0.05 for FFAR 3, and r = 0.39, p &lt; 0.05 for FFAR4). Conclusions: In this study, we show that FFARs may play a role in GERD pathogenesis, particularly in the NERD type. It may be assumed that FFARs, in particular FFAR3 and FFAR4, may have diagnostic and therapeutic potential in GERD