Virulence factors of Enterococcus strains isolated from patients with inflammatory bowel disease

AIM: To determine the features of Enterococcus that contribute to the development and maintenance of the inflammatory process in patients with inflammatory bowel disease (IBD). METHODS: Multiplex polymerase chain reaction (PCR) was applied to assess the presence of genes that encode virulence factors [surface aggregating protein (asa1), gelatinase (gelE), cytolysin (cylA), extracellular surface protein (esp) and hyaluronidase (hyl)] in the genomic DNA of 28 strains of Enterococcus isolated from the intestinal tissues of children with IBD (n = 16) and of children without IBD (controls; n = 12). Additionally, strains with confirmed presence of the gelE gene were tested by PCR for the presence of quorum sensing genes (fsrA, fsrB, fsrC) that control the gelatinase production. Gelatinase activity was tested on agar plates containing 1.6% gelatin. We also analysed the ability of Enterococcus strains to release and decompose hydrogen peroxide (using Analytical Merckoquant peroxide test strips) and tested their ability to adhere to Caco-2 human gut epithelium cells and form biofilms in vitro. RESULTS: A comparison of the genomes of Enterococcus strains isolated from the inflamed mucosa of patients with IBD with those of the control group showed statistically significant differences in the frequency of the asa1 gene and the gelE gene. Furthermore, the cumulative occurrence of different virulence genes in the genome of a single strain of Enterococcus isolated from the IBD patient group is greater than in a strain from the control group, although no significant difference was found. Statistically significant differences in the decomposition of hydrogen peroxide and adherence to the Caco-2 epithelial cell line between the strains from the patient group and control group were demonstrated. The results also showed that profuse biofilm production was more frequent among Enterococcus strains isolated from children with IBD than in control strains. CONCLUSION: Enterococcus strains that adhere strongly to the intestinal epithelium, form biofilms and possess antioxidant defence mechanisms seem to have the greatest influence on the inflammatory process

Pseudomonas aeruginosa biofilm is a potent inducer of phagocyte hyperinflammation

Objective Pseudomonas aeruginosa effectively facilitate resistance to phagocyte killing by biofilm formation. However,b the cross talk between biofilm components and phagocytes is still unclear. We hypothesize that a biofilm provides a concentrated extracellular source of LPS, DNA and exopolysaccharides (EPS), which polarize neighbouring phagocytes into an adverse hyperinflammatory state of activation. Methods We measured the release of a panel of mediators produced in vitro by murine neutrophils and macrophages exposed to various biofilm components of P. aeruginosa cultures. Results We found that conditioned media from a high biofilm-producing strain of P. aeruginosa, PAR5, accumulated high concentrations of extracellular bacterial LPS, DNA and EPS by 72 h. These conditioned media induced phagocytes to release a hyperinflammatory pattern of mediators, with enhanced levels of $TNF-\alpha$, IL-6, IL12p40, $PGE_{2}$ and NO. Moreover, the phagocytes also upregulated COX-2 and iNOS with no influence on the expression of arginase-1. Conclusions Phagocytes exposed to biofilm microenvironment, called by us biofilm-associated neutrophils/macrophages (BANs/BAMs), display secretory properties similar to that of N1/M1-type phagocytes. These results suggest that in vivo high concentrations of LPS and DNA, trapped in biofilm by EPS, might convert infiltrating phagocytes into cells responsible for tissue injury without direct contact with bacteria and phagocytosis

Research on multiculturalism in nursing practice. A review of Polish nursing literature

Introduction. The phenomenon of multiculturalism confronts nurses with new challenges. Therefore, scientific research on multicultural issues in nursing practice is of great importance. Their results can improve both education and clinical practice.Aim. The aim of this paper was to analyse the results of empirical studies available in the Polish academic nursing literature on multiculturalism in nursing practiceMaterial and methods. The research involved a systematic review of the academic nursing literature from 2011-2016. The databases of ranked nursing journals and the Google Scholar database were searched by combination of the following keywords: multiculturalism; culturally different patient; nursing care; multicultural nursing; patient from another culture; cultural sensitivity in nursing care.Results. Searching process resulted with 14 papers that met the inclusion criteria. The dominant research method used was the survey method with the utilisation of authors’ questionnaire and standardized research tools. The study was conducted in different groups, e.g. foreign students, nursing students, health workers, representatives of local communities, followers of some religions and patients. Among the main issues in analyzed research were: the cultural competences of nursing staff, the impact of religious creed on the selected aspects of medical care, the standards of nursing education with regard to patients coming from different cultural backgrounds, the attitudes of Polish society to people from different cultural backgrounds, and the health-related behaviour of people representing different cultural areas. Conclusions. Polish nurses undertake scientific research on various aspects of multiculturalism in medical care. However, there is a need to introduce multidisciplinary and multi-centre scientific research tackling multiculturalism issues in medical care in a broader way

Virulence factors of Enterococcus strains isolated from patients with inflammatory bowel disease

Author contributions: Golińska E performed the majority of the experiments, including the detection of gelatinase activity, measurement of hydrogen peroxide production and the determination of hydrogen peroxide decomposition, and wrote the manuscript; Tomusiak A collected and analysed the data; Gosiewski T performed PCR and multiplex PCR; Więcek G evaluated the adherence to human gut epithelium cells; Machul A and Mikołajczyk D evaluated the biofilm production; Heczko PB and Bulanda M supervised the experiments; and Strus M designed the experiments and supervised the project. Abstract AIM: To determine the features of Enterococcus that contribute to the development and maintenance of the inflammatory process in patients with inflammatory bowel disease (IBD). METHODS: Multiplex polymerase chain reaction (PCR) was applied to assess the presence of genes that encode virulence factors [surface aggregating protein (asa1 ), gelatinase (gelE ), cytolysin (cylA ), extracellular surface protein (esp ) and hyaluronidase (hyl )] in the genomic DNA of 28 strains of Enterococcus isolated from the intestinal tissues of children with IBD (n = 16) and of children without IBD (controls; n = 12). Additionally, strains with confirmed presence of the gelE gene were tested by PCR for the presence of quorum sensing genes (fsrA , fsrB , fsrC ) that control the gelatinase production. Gelatinase activity was tested on agar plates containing 1.6% gelatin. We also analysed the ability of Enterococcus strains to release and decompose hydrogen peroxide (using Analytical Merckoquant peroxide test strips) and tested their ability to adhere to Caco-2 human gut epithelium cells and form biofilms in vitro . RESULTS: A comparison of the genomes of Enterococcus strains isolated from the inflamed mucosa of patients with IBD with those of the control group showed statistically significant differences in the frequency of the asa1 gene and the gelE gene. Furthermore, the cumulative occurrence of different virulence genes in the genome of a single strain of Enterococcus isolated from the IBD patient group is greater than in a strain from the control group, although no significant difference was found. Statistically significant differences in the decomposition of hydrogen peroxide and adherence to the Caco-2 epithelial cell line between the strains from the patient group and control group were demonstrated. The results also showed that profuse biofilm production was more frequent among Enterococcus strains isolated from children with IBD than in control strains. CONCLUSION: Enterococcus strains that adhere strongly to the intestinal epithelium, form biofilms and possess antioxidant defence mechanisms seem to have the greatest influence on the inflammatory process

Chosen aspects of medical care in Poland for patient from the Islamic culture

Chrzan-Rodak Agnieszka, Bąk Jadwiga, Machul Michał, Bieniak Monika, Chałdaś‑Majdańska Justyna, Dobrowolska Beata. Chosen aspects of medical care in Poland for patient from the Islamic culture. Journal of Education, Health and Sport. 2017;7(3):392-399. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.344549 http://ojs.ukw.edu.pl/index.php/johs/article/view/4297 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 1223 (26.01.2017). 1223 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Author (s) 2017; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 12.02.2017. Revised 23.02.2017. Accepted: 28.02.2017. Wybrane aspekty opieki medycznej w Polsce nad pacjentem pochodzącym z kręgu kultury islamu Chosen aspects of medical care in Poland for patient from the Islamic culture Agnieszka Chrzan-Rodak1, Jadwiga Bąk1, Michał Machul1, Monika Bieniak1, Justyna Chałdaś-Majdańska1, Beata Dobrowolska2 1 Studenckie Koło Naukowe przy Katedrze Rozwoju Pielęgniarstwa, Wydział Nauk o Zdrowiu, Uniwersytet Medyczny w Lublinie / Students’ Scientific Association, Department of Nursing Development, Faculty of Health Sciences, Medical University of Lublin 2 Katedra Rozwoju Pielęgniarstwa, Wydział Nauk o Zdrowiu, Uniwersytet Medyczny w Lublinie, opiekun SKN/ Department of Nursing Development, Faculty of Health Sciences, Medical University of Lublin, Students’ Association supervisor Słowa kluczowe: islam, pacjenci zróżnicowani kulturowo, opieka medyczna Key words: Islam, culturally diverse patients, medical care Agnieszka Chrzan-Rodak, Jadwiga Bąk, Michał Machul, Monika Bieniak, Justyna Chałdaś-Majdańska, dr n. hum. Beata Dobrowolska Streszczenie Wstęp. Postępujący proces globalizacji stawia nowe wyzwania przed opieką zdrowotną w Polsce, które dotyczą m.in. zapewnienia bezpieczeństwa kulturowego pacjentom pochodzącym z odmiennych kręgów kulturowych. Cel. Celem pracy jest analiza wybranych aspektów opieki medycznej w Polsce nad pacjentem- przedstawicielem kultury islamu. Metody. Dokonano kontekstowej analizy jakościowej wywiadów zgromadzonych wśród pięciu przedstawicieli islamu zamieszkujących miasto Lublin. Badania zostały przeprowadzone w 2016 roku w Centrum Kultury Islamu w Lublinie. W procesie doboru przedstawicieli islamu zastosowano metodę kuli śnieżnej. Wywiady nagrano a następnie transkrybowano. Wyniki. Analiza jakościowa uzyskanych danych pozwoliła na wyodrębnienie następujących głównych kategorii zagadnień związanych z opieką nad pacjentem z kręgu kultury islamu w praktyce pielęgniarskiej: modlitwa w warunkach szpitalnych; post w warunkach szpitalnych; posiłki w szpitalach; opieka i pielęgnacja a płeć opiekunów; leczenie i leki; wyzwania w opiece nad pacjentem odmiennym kulturowo. Wnioski. Badania pokazały, iż realizacja praktyk religijnych, różnice kulturowe w zakresie spożywanych posiłków, przyjmowanych leków, realizacji wybranych procedur medyczno-opiekuńczych oraz w zakresie komunikacji to te elementy, które wymagają większej uwagi personelu medycznego w procesie opieki nad pacjentem odmiennym kulturowo, a w tym przypadku z kręgu kultury islamu. Pacjenci z kultury islamu przebywający w polskich szpitalach wykazują gotowość dostosowania się do systemu opieki medycznej, w ramach którego objęci są opieką oraz poszukiwania alternatywnych sposobów działania, które pozwolą zachować ich kulturową tożsamość. Istnieje potrzeba kształtowania kompetencji kulturowych studentów kierunków medycznych oraz aktywnych zawodowo pracowników medycznych w celu zapewnienia bezpieczeństwa kulturowego podopiecznym. Abstract Introduction. The progressing globalisation process creates new challenges for healthcare in Poland, which are related mainly providing cultural security for patients from different culture circles. Aim. The objective of the study is to analyse chosen aspects of medical care in Poland for patients from the Islamic culture. Methods. A qualitative, contextual analysis of the material from interviews conducted among five followers of Islam who live in Lublin. The survey was carried out from 20 June to 8 July 2016 at the Islamic Cultural Centre in Lublin. The process of sampling the representatives of Islamic culture involved the snowball sampling method. The interviews were recorded and transcribed. Results. The qualitative analysis of the data obtained made it possible to specify the following categories of issues related to care for patients representing the Islamic culture in nursing practice: prayer in the hospital environment, fasting in hospital conditions, meals in hospitals, care and nursing and the carer's sex, treatment and medications, challenges in care for patients from different culture circles. Conclusions. The survey results show that religious practices, cultural differences related to meals, medications, selected medical and care procedures and communication are issues which require greater attention of medical personnel in the process of care for patients representing different cultures – in this case the Islamic culture. Patients from the Islamic culture staying in Polish hospitals are ready to adjust to the healthcare system and to seek alternative procedures enabling them to preserve their cultural identity. Developing the cultural competence of medical students and occupationally active medical professionals is an important issue aiming at protecting cultural safety of the patient

The Level of Health Literacy of Seniors Living in Eastern Region of Poland. Preliminary Study

Health literacy (HL) is recognised as an important, modifiable factor in the self-management and health performance of elderly people. The aim of this preliminary study was to identify and analyse the level of health literacy among the elderly living in one of the eastern regions in Poland. The cross-sectional study was conducted among a convenience sample of 200 seniors aged 65+ after cognitive pre-screening with the use of the Montreal Cognitive Assessment (MoCA) scale. To collect data, the Polish version of the HLS-EU-Q47 was used. More than half of the elderly surveyed presented problematic levels of general HL (GEN-HL), and also problematic levels of other dimensions: health care health literacy (HC-HL), disease prevention health literacy (DP-HL), and health promotion health literacy (HP-HL). The level of seniors’ HL is dependent on the level of their education, place of living, participation in activities run by Daily Center for the Elderly, and their self-assessment of health condition (p < 0.05). These results imply the important message that there is a need to create initiatives and programs improving health literacy targeted at seniors living in rural areas, those with lower levels of education, and those with poor access to activities organised by institutions supporting seniors