Writing prescriptions by palliative care nurses in Poland

Introduction: The introduction of new permissions, in the field of prescribing medicines and medical devices for nurses and midwives in Poland, took place at the beginning of 2014. Then a draft amendment to the Act on the profession of nurse and midwife was presented by the Ministry of Health. The study aimed to explore nurses’ opinions about the possibility of prescribing drugs and medical devices. Material and methods: The study was conducted in the period from January to February 2020 among 100 nurses related to palliative care from all over Poland. An own survey questionnaire consisting of 23 questions was used. Results: All participants responded to the questionnaire (response rate = 100%). More than half of the respondents (55%) write prescriptions in palliative nursing practice. Most respondents (89%) confirmed that the obtained right to prescribe increases the prestige of the nursing profession and 83% of respondents believed that this right contributes to an improvement of the quality of medical services. A total of 57% of surveyed participants indicated the need to expand a list of drugs that could be prescribed by palliative care nurses. Conclusions: Most of the surveyed nurses expressed views that the obtained possibility to prescribe drugs increases the prestige of the nursing profession and that this right contributes to the improvement of the quality of medical services provided by nurses

Antioxidant Activity of a Red Lentil Extract and Its Fractions

Phenolic compounds were extracted from red lentil seeds using 80% (v/v) aqueous acetone. The crude extract was applied to a Sephadex LH-20 column. Fraction 1, consisting of sugars and low-molecular-weight phenolics, was eluted from the column by ethanol. Fraction 2, consisting of tannins, was obtained using acetone-water (1:1; v/v) as the mobile phase. Phenolic compounds present in the crude extract and its fractions demonstrated antioxidant and antiradical activities as revealed from studies using a β-carotene-linoleate model system, the total antioxidant activity (TAA) method, the DPPH radical-scavenging activity assay, and a reducing power evaluation. Results of these assays showed the highest values when tannins (fraction 2) were tested. For instance, the TAA of the tannin fraction was 5.85 μmol Trolox® eq./mg, whereas the crude extract and fraction 1 showed 0.68 and 0.33 μmol Trolox® eq./mg, respectively. The content of total phenolics in fraction 2 was the highest (290 mg/g); the tannin content, determined using the vanillin method and expressed as absorbance units at 500 nm per 1 g, was 129. There were 24 compounds identified in the crude extract using an HPLC-ESI-MS method: quercetin diglycoside, catechin, digallate procyanidin, and p-hydroxybenzoic were the dominant phenolics in the extract

Effect of osmotic stress and post-stress recovery on the content of phenolics and properties of antioxidants in germinating seeds of grapevine Vitis californica

The tested material consisted of grapevine Vitis californica stratified seeds germinated under optimum conditions (+25°C in water), under osmotic stress (-0.2 MPa in PEG solution) and submitted to recovery after stress (+25°C in water). The germinating seeds were determined to contain tannins, catechins and the following phenolic acids: gallic, caffeic, p-coumaric and ferulic. The acids occurred in free, ester- and glycoside-bound forms. The dominant form of phenolic acids was the ester-bound fraction. Gallic acid was the most abundant phenolic acid in germinating seeds, while ferulic acid appeared in the smallest amounts. Our analysis of tannins demonstrated that osmotic stress depressed their concentration. Presence of catechin group compounds such as catechin and epicatechin was also determined. In each sample epicatechin was dominant. The total concentration of catechin increased under stress conditions and declined during post-stress recovery. Catechins are a constituent of tannins and their increase under osmotic stress is most probably caused by the breakdown of some tannins in seeds germinating under stress conditions. Samples submitted to osmotic stress were also found to contain less of total phenolic compounds, whereas in samples which underwent post-stress recovery the total level of phenolic compounds increased. Compared to extracts from seeds germinating under optimum conditions, osmotic stress depressed the capacity of extract to scavenge DPPH● (2,2-diphenyl-1-picrylhydrazyl) and ABTS●+ – 2,2-Azino-bis (3-etylbenzothiazoline-6-sulfonic acid) free radicals, but the antioxidant activity rose in seeds submitted to recovery after stress. Positive correlation was therefore demonstrated between the total content of phenolic acids in germinating grapevine seeds and the reducing power of extracts obtained from these seeds and their free radical scavenging activity. The results suggest that osmotic stress inhibits the activity of antioxidizing enzymes in germinating grapevine seeds. Thus, the antioxidative defence system is largely blocked under osmotic stress. It seems that a very high oxidoreductive potential in grapevine tissues prior to occurrence of osmotic stress is essential for maintaining proper homeostasis of oxidation and reduction reactions

Osteoporosis in thyroid diseases

Hormony tarczycy odgrywają istotną rolę w regulacji metabolizmu i przebudowy tkanki kostnej w warunkach fizjologii i w przebiegu zaburzeń funkcji gruczołu tarczowego. Wprowadzenie metod densytometrycznych do diagnostyki osteoporozy umożliwiło ocenę wpływu zarówno nadczynności jak i niedoczynności tarczycy oraz ich leczenia na gęstość mineralną kośćca. Ponadto stała się możliwa ocena wpływu leczenia egzogennymi hormonami tarczycy na układ kostny. Autorzy przedstawili mechanizmy działania hormonów tarczycy na tkankę kostną oraz przeanalizowali obecny stan wiedzy na temat wpływu leczenia tyroksyną w dawkach substytucyjnych i supresyjnych na gęstość mineralną kośćca. Omówiono także działanie hormonów tarczycy na układ kostny z uwzględnieniem okresu przed- i pomenopauzalnego. Podkreślono dużą rozbieżność danych z piśmiennictwa i zasygnalizowano ich przyczyny.Thyroid hormones play the essential role in the regulation of metabolism and bone remodeling in physiological conditions and in the course of thyroid dysfunction. Introduction of densitometry to the diagnostics of osteoporosis has made possible the evaluation of influence of both hyperthyroidism and hypothyroidism and their treatment on bone mineral density. Moreover it became possible to estimate the influence of treatment with exogenous thyroid hormones on the skeletal system. Authors presented mechanisms of the thyroid hormones action on bone tissue and analysed current state of knowledge concerning the influence of the thyroxine treatment with replacement and suppressive doses on the bone mineral density. The influence of thyroid hormones on the skeletal system with respect to premenopausal and postmenopausal period was also discussed. Great discrepancies in literature data and its reasons were underlined

A Novel Monoallelic Nonsense Mutation in the NFKB2 Gene Does Not Cause a Clinical Manifestation

NF-κB signaling, acting through NFKB1 dependent canonical and NFKB2 dependent non-canonical pathways plays a critical role in inflammatory and immune responses. Recent studies have associated mutations in these two genes with a common variable immunodeficiency (CVID). While evaluating a female patient seeking a diagnosis explaining her recurrent infections, we found a novel heterozygous c.1831C > T (p.Arg611∗) nonsense mutation in the NFKB2 gene which introduces a Stop codon in the ankyrin repeat domain of p100. Whole exome sequencing (WES) analysis, followed by Sanger sequencing, identified this previously unknown mutation in two other family members. Penetrance of the c.1831C > T variant was assessed by flow-cytometry and protein expression in peripheral blood mononuclear cells (PBMC); whereas, activation of the NF-κB2 signaling pathway was examined through immunoblotting and real-time PCR. Heterozygous c.1831C > T variant led to the expansion of lymphocyte B subpopulations with concomitant reduction of plasmablasts, low IgG levels, and accumulation of p52 in PBMC. On the other hand, tested subjects had normal levels of IgM, IgA, IgE and no impairment in lymphocytes proliferation. Although evaluated patients did not fulfill all clinical features of CVID, their health should be monitored in the future for possible late manifestation of the disease. In conclusion, we showed that NFKB2 haplodeficiency caused by c.1831C > T nonsense mutation is asymptomatic, possibly due to the compensatory mechanisms and allele redundancy

Perinatal outcome according to chorionicity in twins — a Polish multicenter study

Objectives: The aim of the study was to analyze the perinatal outcome of twin gestations and estimate the influence of chorionicity on the outcome in a large cohort of twin pregnancies in Poland. Material and methods: A retrospective analysis of 465 twin deliveries in 6 Polish centers in 2012 was conducted. Baseline characteristics, the course of pregnancy and labor, as well as the neonatal outcome were analyzed in the study group and according to chorionicity. Results: A total of 356 twin pregnancies were dichorionic (DC group) (76.6%), and 109 were monochorionic (MC group) (23.4%). There were no differences in the occurrence of pregnancy complications according to chorionicity, except for IUGR of at least one fetus (MC 43.1% vs. DC 34.6%; p = 0.003). 66.5% of the women delivered preterm, significantly more in the MC group (78% vs. 62.9%; p = 0.004). Cesarean delivery was performed in 432 patients (92.9%). Mean neonatal birthweight was statistically lower in the MC group (2074 g vs. 2370 g; p < 0.001). Perinatal mortality of at least one twin was 4.3% (2.8% in the DC group vs. 9.2% in the MC group; p = 0.004). Neonatal complications, including NICU admission, respiratory disorders, and infections requiring antibiotic therapy, were significantly more often observed among the MC twins. Conclusions: The overall perinatal outcome in the presented subpopulation of Polish twins and its dependence on cho­rionicity is similar to the reports in the literature. Nevertheless, the rates of preterm and cesarean deliveries remain higher. It seems that proper counselling of pregnant women and education of obstetricians may result in reduction of these rates

Presence of Caffeic Acid in Flaxseed Lignan Macromolecule

Phenolic compounds were extracted from defatted flaxseeds using ethanol-dioxane (1:1, v/v). The crude extract obtained was purified using Amberlite XAD-16 column chromatography with water and methanol as mobile phases. RP-HPLC and SE-HPLC showed a lignan macromolecule (LM) as a dominant phenolic compound in the purified extract. After the alkaline hydrolysis of LM caffeic acid glucoside (CaAG) was isolated using a semi-preparative HPLC and its structure was confirmed by LC-ESI-MS. In LM of the investigated flaxseed, one molecule of caffeic acid corresponded with five molecules of p-coumaric acid and two molecules of ferulic acid. The presence of caffeic acid in the lignan molecule might be very beneficial due to its high antioxidant activity