Eozynofilowe choroby przewodu pokarmowego

Pierwotnymi eozynofilowymi chorobami przewodu pokarmowego (EGID) określa się choroby, w których stwierdza się nacieki eozynofilów w ścianie przewodu pokarmowego przy niewystępowaniu innych znanych przyczyn eozynofilii tkankowej. W zależności od zajętego odcinka przewodu pokarmowego wyróżnia się eozynofilowe zapalenie przełyku (najczęstsza postać EGID) i rzadziej spotykane eozynofilowe zapalenie żołądka i/lub jelita cienkiego oraz eozynofilowe zapalenie jelita grubego. Pierwotne eozynofilowe choroby przewodu pokarmowego mają podłoże alergiczne. Decydującą rolę odgrywa autoimmunologiczna reakcja wywołana przez limfocyty Th2, ale także IgE-zależna. Większość pacjentów z EGID ma wywiady chorób atopowych oraz uczulenie na alergeny pokarmowe lub wziewne. Głównymi objawami eozynofilowego zapalenia przełyku u dorosłych są: dysfagia, utknięcie kęsa pokarmowego, ból w klatce piersiowej. Objawy eozynofilowego zapalenia żołądka i jelit są niespecyficzne, różnorodne i zależą od tego, w której warstwie ściany przewodu pokarmowego toczy się zapalenie. Nie ma patognomonicznych laboratoryjnych, endoskopowych ani radiologicznych cech EGID, a rozpoznanie opiera się na obrazie klinicznym, badaniu histologicznym, w którym stwierdza się nacieki z eozynofilów w ścianie przewodu pokarmowego oraz wykluczeniu innych przyczyn eozynofilii. W leczeniu EGID główną rolę odgrywa usunięcie alergenu (dieta elementarna lub inne diety eliminacyjne) oraz glukokortykosteroidy, podawane miejscowo lub systemowo

Predictors of airway hyperreactivity in house dust mite allergic patients

Introduction: Airway hyperresponsiveness (AHR) is a cardinal feature of asthma. Asthma is a heterogenous disorder which consists of different phenotypes and endotypes. Mechanisms leading to AHR may differ in different asthma subtypes. Allergy to perennial allergens, including house dust mites (HDM) is a major risk factor for asthma development. The aim of this study was to determine predictors of AHR in a well-characterized population of HDM-allergic patients.Material and methods: In a retrospective analysis 843 patients with HDM-allergic rhinitis with/without asthma were evaluated. The following parameters were included in the analysis: serum concentration of total (t)- and Dermatophagoides pteronyssinus (Dp)-specific IgE, fractional exhaled nitric oxide concentration (FeNO), lung function tests, bronchial challenge with histamine, age sex, and body mass index (BMI). Linear regression analysis was used to determine predictors of AHR.Results: In a simple linear regression analysis baseline lung function results expressed as either forced expiratory volume in 1 s (FEV1) or maximal expiratory flow at 50% of the forced vital capacity (MEF50), FeNO, tIgE, DpIgE, age and BMI affected AHR. A multiple regression analysis demonstrated that in the whole group of HDM-allergic patients the most important, independent predictors of AHR were MEF50, FeNO and DpIgE.Conclusion: Even in a well-characterized asthma phenotype several processes participate in development of AHR. Major, independent predictors of AHR: lung function parameters, FeNO and DpIgE indicate possible targets for therapeutic intervention in a population of HDM-allergic patients

Medicinal product and dietary supplement as waste - legal issues

The issue of waste is a topic widely discussed at both European and national levels. The insufficient share of separately collected waste in the stream and the too large amount of waste sent to landfills, combined with the need for Poland to implement the concept of a circular economy, makes it necessary to analyze the possibility of making changes, primarily in the legal area. Their goal should be to minimize the amount of waste generated and to more effectively counteract the threats resulting from the presence of waste in the environment. Waste of a special nature are medicinal products generated both in pharmacies and households. Improper handling of unnecessary/expired medicinal products may cause negative effects on both the environment and human health. This problem also applies to dietary supplements, which are treated as food products under the law, even though they may contain compounds that may have a negative impact on health and on the environment. Proper handling of waste from medicinal products and dietary supplements depends on the correct classification of these types of waste. The aim of the work is to analyze the regulations regarding the classification of waste from medicinal products (both generated in pharmacies and households) and dietary supplements, as well as legal problems related to this classification. First of all, the classification of waste resulting from dietary supplements is controversial. This is important because correct categorization determines the appropriate, safe method of waste disposal (thermal transformation, storage in landfills). The work also points to problems in defining concepts at the intersection of environmental protection regulations and regulations relating to medicinal products. The analysis was limited to waste from medicinal products and dietary supplements generated in pharmacies and households and does not apply to waste from pharmaceutical plants and chemicals used in pharmacies to produce prescription and pharmaceutical drugs

Diffusion tensor tractography imaging in pediatric epilepsy – A systematic review

Purpose Recent years brought several experimental and clinical reports applying diffusion tensor tractography imaging (DTI) of the brain in epilepsy. This study was aimed to evaluate current evidence for adding the DTI sequence to the standard diagnostic magnetic resonance imaging (MRI) protocol in pediatric epilepsy. Material and methods Rapid and qualitative systematic review (RAE, Rapid Evidence Assessment), aggregating relevant studies from the recent 7 years. The PubMed database was hand searched for records containing terms “tractography AND epilepsy.” Only studies referring to children were included; studies were rated using “final quality of evidence.” Results Out of 144 screened records, relevant 101 were aggregated and reviewed. The synthesis was based on 73 studies. Case-control clinical studies were the majority of the material and comprised 43.8% of the material. Low ‘confirmability’ and low ‘applicability’ referred to 18 and 17 articles (29.5% and 27.9%), respectively. The sufficient quality of evidence supported performing DTI in temporal lobe epilepsy, malformations of cortical development and prior to a neurosurgery of epilepsy. Conclusions The qualitative RAE provides an interim estimate of the clinical relevance of quickly developing diagnostic methods. Based on the critical appraisal of current knowledge, adding the DTI sequence to the standard MRI protocol may be clinically beneficial in selected patient groups with childhood temporal lobe epilepsy or as a part of planning for an epilepsy surgery

Protokół terapeutyczny w dokumentowaniu procesu napromieniania pacjentów w zakładzie radioterapii

SummaryA decision to start radiotherapy should be based on at least two documents:1.Written standards of obligatory clinical procedures which are in fact radiotherapeutic schemes.2.Therapeutic protocols describing all mandatory procedures performed to ensure a safe and proper treatment of the patient.The range of activities described in the therapeutic protocol is very wide.It includes all initial procedures implemented in the simulation room, the CT scanner, in the treatment planning system and the mould- room, and it describes the verification process of the treatment plan, mandatory to start radiotherapy.The therapeutic protocol describes in details what and how should be checked by an internal control system and it qualifies the demands required to sum up the treatment and its’ accordance with the planned radiotherapy scheme.All the activities performed are recorded in a QA protocol, which is an integral part of the therapeutic protocol.In this paper we present the therapeutic protocol in force in the Regional Oncological Hospital in Szczecin and the QA and in-vivo protocols, which assure safe radiotherapy of the patient

The impact of IT systems on the safety and competitiveness of construction enterprises

PURPOSE: The article aims to show the impact of IT systems on the safety and competitiveness of construction enterprises.APPROACH/METHODOLOGY/DESIGN: The main research methods are a review of national and world scientific and practical literature and a quantitative survey among construction companies in selected European Union countries.FINDINGS: The growing importance of IT systems in construction companies contributes to their development, resulting in the availability of information to an increasing number of employees, which translates into a higher quality of decisions made and, in turn, a competitive position.PRACTICAL IMPLICATIONS: The practical implications of the research results included in the article will constitute recommendations for activities in managing companies that can be used in business practice, which will translate into higher financial results.The need to replace software is dictated by the pace of scientific and technical progress, because the condition for purchasing it is the desire to have innovative IT tools that provide a temporary advantage over the competition.ORIGINALITY/VALUE: The original value of the article is the quantitative analysis of the impact of introduced IT systems on the competitiveness of construction companies.peer-reviewe

A radiotherapy protocol to document the process of irradiation of patients at the radiotherapy department

A decision to start radiotherapy should be based on at least two documents:1.Written standards of obligatory clinical procedures which are in fact radiotherapeutic schemes.2.Therapeutic protocols describing all mandatory procedures performed to ensure a safe and proper treatment of the patient.The range of activities described in the therapeutic protocol is very wide.It includes all initial procedures implemented in the simulation room, the CT scanner, in the treatment planning system and the mould- room, and it describes the verification process of the treatment plan, mandatory to start radiotherapy.The therapeutic protocol describes in details what and how should be checked by an internal control system and it qualifies the demands required to sum up the treatment and its’ accordance with the planned radiotherapy scheme.All the activities performed are recorded in a QA protocol, which is an integral part of the therapeutic protocol.In this paper we present the therapeutic protocol in force in the Regional Oncological Hospital in Szczecin and the QA and in-vivo protocols, which assure safe radiotherapy of the patient

Ozonation of Whole Blood Results in an Increased Release of Microparticles from Blood Cells.

Autohemotherapy with ozonated blood is used in the treatment of a broad spectrum of clinical disorders. Ozone demonstrates strong oxidizing properties and causes damage to cell membranes. The impact of whole-blood ozonation on the release of microparticles from blood and endothelial cells and the concentration of selected markers in the hemostatic system (APTT, PT, D-dimer, fibrinogen) were investigated. Venous blood, obtained from 19 healthy men, was split into four equal parts and treated with air, 15 µg/mL ozone, or 30 µg/mL ozone, or left untreated. The number and types of microparticles released were determined using flow cytometry on the basis of surface antigen expression: erythrocyte-derived microparticles (CD235+), platelet-derived microparticles (CD42+), leukocyte-derived microparticles (CD45+), and endothelial-derived microparticles (CD144+). The study is the first to demonstrate that ozone induces a statistically significant increase in the number of microparticles derived from blood and endothelial cells. Although statistically significant, the changes in some coagulation factors were somewhat mild and did not exceed normal values

Wokół rekodyfikacji prawa cywilnego. Prace jubileuszowe

Praca recenzowana / Peer-reviewed paperPrezentowana książka to głos w debacie nad stanem naszej kodyfikacji cywilnej. Jubileusz 50-lecia uchwalenia Kodeksu cywilnego, Kodeksu rodzinnego i opiekuńczego oraz Kodeksu postępowania cywilnego zbiega się z jubileuszem Profesora Janusza Szwai1. Profesor, wybitny cywilista, obchodzi swoje 80. urodziny, mija także 50 lat od obrony przez Niego doktoratu. Jest to doskonała okazja by przyjrzeć się propozycjom zmian prawa cywilnego płynących z różnych środowisk akademickich. Wszak dużą część swojego życia Profesor Szwaja poświęcił pracom legislacyjnym, ich komentowaniu czy krytykowaniu. Sam aktywnie w zmianach różnych kodyfikacji uczestniczył. Jego poglądy zawsze były wyważone. Dziś właśnie taki wyważony głos w dyskusji nad kształtem polskiego prawa cywilnego stał się niezbędny