Occupational injury rates in personnel of emergency medical services

[i][/i][b]Introduction and objectives. [/b]The system of emergency medical services (EMS) in Poland was established in 2006. The risk of occupational injuries to EMS personnel is very high, irrespective of the country where they operate, as they face many hazards in their everyday work. The aim of this study is to describe the type, incidence and consequences of occupational accidents among the personnel of the National Emergency Medical Services in Poland (NEMS – land and air ambulance crews) in 2008–2012. [b]Material and methods:[/b] The study reviewed all occupational accidents among the EMS personnel reported to the National Labour Inspectorate in 2008–2012. [b]Results[/b]: In the period reported, the number of accidents decreased from 32 in 2008 to just 6 in 2012. Traffic accidents predominated and most of the victims were male paramedics under 30 years of age. The most common injuries included multiple organ injuries and injuries of the cervical spine, chest and trunk. [b]Conclusions:[/b] The growing professional experience of the EMS personnel has a beneficial effect on occupational injury rates as they tend to decrease with longer employment. Occupational accidents are definitely more common among ambulance crews than in the personnel of other organizational units of the National Emergency Medical Services

The Opinions of Polish Nurses and Patients on Nursing Protests

The aim of this study is to explore nurses’ and patients’ opinions about nurses in Poland going on strike. The study was carried out in Poland between January and June 2009, using 150 nurses and 150 hospitalized patients. The study was conducted using two questionnaire surveys. The main reasons why nursing strikes are organized, in the opinions of nurses, are: higher wages, the improvement of working conditions and the improvement of the image of the nursing profession. The main reasons why nursing strikes are organized, in the opinions of patients, are: higher wages, not abiding standards of employment by government and the improvement of the image of the nursing profession. The main reasons for a lack of active participation in strikes are holidays and occupational and economic matters. Patients and nurses support nursing strikes. Both nurses (53.3%) and patients (42%) said that organizing nursing strikes is right and might improve the occupational situation of nurses

Ocena przydatności testu Hand Grip we wczesnej profi laktyce nadciśnienia tętniczego wśród młodzieży szkół ponadgimnazjalnych w regionie południowo-wschodniej Polski — badanie przekrojowe

Introduction. It is assessed that the increased reaction of arterial pressure to physical exertion occurs in about 20% of healthy young people and it is connected with hyperkinetic reaction of the circulatory system. Early identifi cation in young people may be of vital importance in early prophylactics and treatment of arterial hypertension (HT). The aim was to assess the relation between the use of the Hand Grip Test (HGT) and early diagnosis of the primary arterial hypertension (PHT) in youth aged 16–19.Material and method. Research was carried out using a survey questionnaire among 511 people aged 16–19 and their parents. The surveyed youth had blood pressure measured in various conditions, including after a provocative stimulus — HGT. In the statistical study we used the ANOVA single factor analysis of variance, χ2 independence test, the V-Kramer test, the tau-b Kendall test and the method: percentages (%), arithmetical average (X) and standard deviation (SD).Results. Increased pressure rise after HGT test regarded more frequently the systolic aspect (34.8%) rather than the diastolic aspect (7.0%) (p < 0.001). Increased response of systolic blood pressure was observed more frequently in persons with its elevated, rather than normal values (p < 0.05). Increased response for both systolic and diastolic blood pressure was found in persons with a high HT intensity history in the family more often than in youth with low hyper intensity or no propensity towards HT, with predominance of systolic pressure (p < 0.01 vs. p < 0.05). Conclusions. Our research shows that the HGT, which is used to detect hyper reactivity of the circulatory system, is a viable method for identifi cation of people susceptible to PHT. The application of the test may result in the lowered costs of treatment of people suffering from a hypertension disease.Wstęp. Szacuje się, że zwiększona reakcja ciśnienia tętniczego (HT) na wysiłek fizyczny występuje u około 20% młodych zdrowych osób i jest związana z hiperkinetyczną reakcją układu sercowo-naczyniowego. Wczesna identyfi kacja młodych osób może mieć istotne znaczenie we wczesnej profilaktyce i leczeniu nadciśnienia tętniczego. Celem pracy była ocena związku między stosowaniem Testu Hand Grip (HGT) a wczesnym wykrywaniem pierwotnego nadciśnienia tętniczego (PNT) u młodzieży w wieku 16–19 lat. Materiał i metody. Badania przeprowadzono metodą wywiadu z użyciem kwestionariusza wśród 511 osób w wieku 16–19 lat i ich rodziców. U młodzieży wykonano pomiary ciśnienia tętniczego w różnych warunkach, w tym po bodźcu prowokacyjnym (HGT). W opracowaniu statystycznym wykorzystano jednoczynnikową analizę wariancji ANOVA, test niezależności χ2, test V-Kramera, test tau-b Kendalla oraz metody statystyki opisowej: wartości procentowe (%), średnia arytmetyczna (x) i odchylenie standardowe. Wyniki. Zwiększony przyrost ciśnienia po teście HGT dotyczył częściej komponenty skurczowej (34,8%) niż rozkurczowej (7,0%) (p < 0,001). Hiperreakcję skurczowego ciśnienia tętniczego częściej obserwowano u osób z jego podwyższonymi niż prawidłowymi wartościami (p < 0,05). Hiperreakcja zarówno ciśnienia skurczowego, jak i rozkurczowego częściej dotyczyła osób w grupie z dużą intensywnością HT w rodzinie niż młodzieży z małą intensywnością lub brakiem obciążenia w kierunku HT, z przewagą ciśnienia skurczowego (p < 0,01 v. p < 0,05) Wnioski. Z badania wynika, że HGT, wykrywający nadreaktywność układu sercowo-naczyniowego jest dobrą metodą do identyfikacji osób zagrożonych PNT. Zastosowanie testu może przynieść wymierne efekty w postaci zmniejszenia w przyszłości nakładów na leczenie osób z chorobą nadciśnieniową

Niskie dawki rasburykazy w zapobieganiu zespołowi lizy guza u chorej z chłoniakiem z dużych komórek B - opis przypadku

Acute tumor lysis syndrome (ATLS) is a group of metabolic complications that can occur as a result of acute lysis of malignant cells after initiation of cytostatic treatment or spontaneously even before introducing chemotherapy. Usually it is observed in patients with hematologic malignancies or solid tumors with high proliferative index. Since ATLS might be life-threatening, it is necessary to identify risk factors of this complication and to introduce prompt prophylactic treatment. Previously, it consisted of hydration, allopurinol administration and urine alcalinization. At present the new possibility of intervention gives us rasburicase - a recombinant urate oxidase, which directly decreases uric acid level catalyzing its conversion to a soluble, easily excreteable metabolite allantoin. High costs of rasburicase treatment at doses recommended by the manufacturer (0.2 mg/kg for 5 days), may discourage from its everyday usage. Here we present the effective administration of lower doses of rasburicase in combination with allopurinol to prevent development of clinical tumor lysis syndrome (CTLS) in a patient with diffuse large B-cell lymphoma. Administration of a single dose of rasburicase (4.5 mg) reduced plasma uric acid level from 14.3 to 0.4 mg/dl which continued to be low during subsequent CHOP chemotherapy. Such a management allowed us to achieve anticipated clinical effect with costs reduction of 96%.Zespół ostrego rozpadu guza to zmiany metaboliczne, do których dochodzi wskutek nagłego rozpadu komórek nowotworowych na początku leczenia cytostatycznego lub jeszcze przed jego wdrożeniem. Zazwyczaj dotyczy chorych z rozrostami hematologicznymi, a także guzami litymi o dużym indeksie proliferacyjnym. Występowanie zespołu ostrego rozpadu guza może wiązać się z zagrożeniem życia pacjenta, dlatego niezbędna jest identyfikacja czynników ryzyka rozwoju tego powikłania oraz wczesne wdrożenie profilaktyki. Dotychczas w ramach profilaktyki stosowano odpowiednie nawodnienie, allopurinol oraz alkalizację moczu. Obecnie istnieje nowa możliwość - zastosowanie rasburykazy, rekombinowanej oksydazy moczanowej, katalizującej rozkład kwasu moczowego do rozpuszczalnego w wodzie metabolitu alantoiny, łatwo wydzielanej przez nerki. Dawki leku zalecane przez producenta (0,2 mg/kg mc. przez 5 dni) i wynikające z tego koszty leczenia mogą zniechęcać do powszechniejszego zastosowania rasburykazy. W niniejszej pracy przedstawiono skuteczność niskich dawek (4,5 mg) rasburykazy w połączeniu z allopurinolem w profilaktyce rozwoju klinicznego zespołu lizy guza u chorej z chłoniakiem z dużych komórek B, u której już po jednorazowym podaniu rasburykazy uzyskano zmniejszenie stężenia kwasu moczowego w surowicy krwi z 14,3 do 0,4 mg/dl. Wartość tę utrzymano w trakcie następowo podanej chemioterapii CHOP. Dzięki takiemu postępowaniu uzyskano pożądany efekt kliniczny z jednoczesnym obniżeniem kosztów leczenia o 96%

E-learning practice at medical universities in Poland in the perspective of the SARS-CoV-2 pandemic

The epidemiological situation resulting from the SARS-CoV-2 pandemic caused the Polish universities to fully switch to distance education in March 2020. Medical e-learning has not yet been broadly implemented into the education process. Therefore, examples of successful e-learning implementations or the organization of the process of medical e-learning offer a valuable source of knowledge today, which is needed immediately. The article presents e-learning practices at the Polish medical universities during the SARS-CoV-2 epidemic during the period from March to September 2020, covering seven universities in Poland that offer medical and health studies. The organization and implementation of e-learning classes is presented, including knowledge evaluation practices, providing example decisions issued by university rectors, on which the teaching process was based. A detailed presentation of the schools’ organizational units or workgroups that played an important role in the process of coordination of measures supporting e-education is also included. The article also presents a description of the software applications, utilities, and services used at the schools in the course of the process of online education. Below are some examples of specific such implementations in selected university courses

Towards the development of a novel Ex Ovo model of infection to pre-screen biomaterials intended for treating chronic wounds

This communication reports preliminary data towards the development of a live ex vivo model of persistent infection that is based on the chick embryo chorioallantoic membrane (CAM), which can be used for pre-screening biomaterials with antimicrobial properties for their antimicrobial and angiogenic potential. Our results showed that it was possible to infect chicken embryos with Staphylococcus aureus, one of the main types of bacteria found in the persistent infection associated with chronic wounds, and maintain the embryos’ survival for up to 48 h. Survival of the embryos varied with the dose of bacteria inoculum and with the use and time of streptomycin application after infection. In infected yet viable embryos, the blood vessels network of the CAM was maintained with minimal disruption. Microbiological tests could confirm embryo infection, but quantification was difficult. By publishing these preliminary results, we hope that not only our group but others within the scientific community further this research towards the establishment of biomimetic and reproducible ex vivo models of persistent infection

Medical cannabis: Mechanisms of action and therapeutic targets

Introduction: In recent years, multiple publications underscored many beneficial properties associated with medical marihuana. Its current applications encompass pain relief, multiple sclerosis, the treatment of anxiety disorders, Dravet syndrome and other. It can potentially extent to the treatment of patients with fibromyalgia or in people with diabetic complications. The expansive potential of medical cannabis in the prevention and treatment of many diseases is seen in its complex and multidirectional mechanisms of action. Medical marihuana has impact on cannabinoid receptors, and it exerts effects through many other molecular targets. Aim of the study: This review seeks present mechanisms of action of medical marihuana and explore its potential therapeutic targets. Materials and methods: A comprehensive review of literature available in the PubMed and Google Scholar databases was performed, using the following keywords: "medical marihuana", "medical cannabis", "medical marihuana mechanism of action", "therapeutic targets of medical marihuana", "endocannabinoid system", “medical marihuana in pain treatment”, “medical marihuana amygdala body”, “medical marihuana serotonin receptors”. Conclusions: Medical marihuana emerges as a promising candidate in the treatment of many diseases and common condition. However, further research is imperative to ascertain the effects of the drug and transform it into an effective medication which maximizes benefits and minimalizes side effects

Przezustna miotomia endoskopowa (POEM) — nowy standard w leczeniu achalazji?

Achalazja, czyli kurcz wpustu, jest rzadką przewlekłą, czynnościową chorobą polegającą na wzmożonym ciśnieniu dolnego zwieracza przełyku, jego upośledzonej relaksacji i utracie prawidłowej perystaltyki przełyku. Objawia się dysfagią, bólem w klatce piersiowej, regurgitacją oraz wtórną do tych objawów utratą masy ciała. Diagnostyka achalazji opiera się na kontrastowym badaniu przełyku oraz manometrii wysokiej rozdzielczości. Na podstawie tego ostatniego badania wyróżniono trzy typy achalazji, a także inne typy zaburzeń czynnościowych przełyku. Do niedawna „złotym standardem” w leczeniu achalazji była miotomia laparoskopowa z fundoplikacją. Inne stosowane metody to rozszerzanie pneumatyczne balonami o dużych średnicach lub, w wybranych przypadkach, iniekcje toksyny botulinowej w okolicę dolnego zwieracza przełyku. Nową metodą leczenia achalazji jest przezustna miotomia endoskopowa (POEM). Cechuje się ona mniejszą inwazyjnością oraz podobną skutecznością i profilem bezpieczeństwa co miotomia laparoskopowa. Dzięki tym zaletom technika POEM rozpowszechniła się w ostatnich latach w wielu ośrodkach klinicznych na świecie i w niedługiej przyszłości może stać się metodą z wyboru w leczeniu achalazji

Not Just a Pot: Visual Episodic Memory in Cannabis Users and Polydrug Cannabis Users: ROC and ERP Preliminary Investigation

Background While research has consistently identified an association between long-term cannabis use and memory impairments, few studies have examined this relationship in a polydrug context (i.e., when combining cannabis with other substances).Aims: In this preliminary study, we used event-related potentials to examine the recognition process in a visual episodic memory task in cannabis users (CU) and cannabis polydrug users (PU). We hypothesized that CU and PU will have both–behavioral and psychophysiological–indicators of memory processes affected, compared to matched non-using controls with the PU expressing more severe changes.Methods 29 non-using controls (CG), 24 CU and 27 PU were enrolled into the study. All participants completed a visual learning recognition task while brain electrical activity was recorded. Event-related potentials were calculated for familiar (old) and new images from a signal recorded during a subsequent recognition test. We used receiver operating characteristic curves for behavioral data analysis.Results The groups did not differ in memory performance based on receiver operating characteristic method in accuracy and discriminability indicators nor mean reaction times for old/new images. The frontal old/new effect expected from prior research was observed for all participants, while a parietal old/new effect was not observed. While, the significant differences in the late parietal component (LPC) amplitude was observed between CG and PU but not between CG and CU nor CU and PU. Linear regression analysis was used to examine the mean amplitude of the LPC component as a predictor of memory performance accuracy indicator. LPC amplitude predicts recognition accuracy only in the CG.Conclusion The results showed alterations in recognition memory processing in CU and PU groups compared to CG, which were not manifested on the behavioral level, and were the most prominent in cannabis polydrug users. We interpret it as a manifestation of the cumulative effect of multiple drug usage in the PU group