Extrinsic allergic pneumonitis - classification, pathogenesis, diagnosis

Introduction and objective: Extrinsic allergic pneumonitis (AZPP) is an inflammatory disease of the lung parenchyma and bronchioles, caused by inhalation of organic and inorganic antigens. The pathhomechanism of the disease is based on the binding of the antigen with precipitins to form immune complexes that are responsible for the formation of acute inflammation in the lung tissue. The resulting inflammation is a type III and type IV hypersensitivity reaction. In the clinical course, azpp is divided into acute, subacute and chronic phases. The course of the disease varies depending on the type and duration of exposure to the antigen. It is most often manifested by shortness of breath, coughing and the progression of the disease leads to respiratory failure. Review methods: While writing the thesis, a database was used, ie Pubmed and Google Scholar. Brief description of the stage of knowledge: Extrinsic allergic pneumonitis requires a thorough differential diagnosis, which includes laboratory tests, functional tests, imaging tests, inhalation provocation tests and lung biopsy. The mainstay of treatment is to avoid exposure to the antigen. In severe disease, systemic corticosteroid therapy is indicated. Summary: Correct diagnosis is a big problem because of the differences in symptoms and the severity of the disease among patients. Expanding the knowledge about the clinical course of the disease or its pathogenesis will affect the effectiveness of diagnostics and help to develop new methods of treatment. &nbsp

Manifestations of the pediatric multisystem inflammatory syndrome temporally related with SARS-CoV-2 (PIMS) in the gastrointestinal, cardiovascular, nervous and respiratory systems.

Introduction and objective: The course of the pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS) is not fully understood. In most cases, complications are so severe that the patients require hospitalization. The aim of this study is to discuss the most common symptoms in the course of PIMS in the individual systems. Review methods: The Medline database (Pubmed) was searched in March 2022 using the keywords: PIMS symptoms, MIS-C manifestations, hyperinflammation, post-COVID. English and Polish language papers published between 2020 and 2022 were selected. Brief description of the state of knowledge: Studies show that the most frequently occuring symptoms are fever, followed by gastrointestinal manifestations. However, the most serious complications have been reported in thecardiovascular system. It is estimated that up to half of the patients develop left ventricular failure or shock, and a quarter may develop coronary artery aneurysms. A large percentage of patients diagnosed with PIMS also manifest nervous system symptoms. In addition to symptoms, organic brain lesions have been described in imaging studies. In contrast to COVID-19 disease, respiratory complications are rare in PIMS. Respiratory failure, if present, usually develops secondary to cardiovascular failure. Summary: The current reports allow to state that PIMS is a rare, but serious disease affecting children most often in school age. Symptoms are not specific and may be different for each patient. Since the disease is difficult to diagnose, criteria have been developed that include the most common symptoms as well as a link to SARS-CoV-2 exposure. Key words: PIMS symptoms; MIS-C manifestations; hyperinflammation; post-COVIDWprowadzenie i cel pracy: Przebieg wieloukładowego zespołu zapalnego związanego z SARS-CoV-2 (PIMS) nie jest do końca poznany. W większości przypadków powikłania są na tyle poważne, że pacjenci wymagają hospitalizacji. Celem pracy jest omówienie najczęściej występujących objawów w przebiegu PIMS w poszczególnych układach. Materiał i metoda: W marcu 2022 roku została przeszukana baza danych Medline (Pubmed) przy użyciu słów kluczowych: PIMS symptoms, MIS-C manifestations, hyperinflammation, post-COVID. Wybrane zostały prace w języku angielskim i polskim, opublikowane w latach 2020-2022. Opis stanu wiedzy: Badania pokazują, że najczęściej, zaraz po gorące, występują dolegliwości ze strony układu pokarmowego. Najpoważniejsze powikłania odnotowano jednak w układzie sercowo-naczyniowym. Szacuje się, że nawet u połowy pacjentów dochodzi do niewydolności lewokomorowej lub wstrząsu, a u jednej czwartej mogą rozwinąć się tętniaki tętnic wieńcowych. Duży odsetek chorych z rozpoznanym PIMS manifestuje również objawy ze strony układu nerwowego. Poza objawami podmiotowymi opisywano również zmiany organiczne mózgu. W przeciwieństwie do choroby COVID-19 powikłania w układzie oddechowym występują rzadko. Niewydolność oddechowa, jeżeli występuje, najczęściej rozwija się wtórnie do niewydolności układu krążenia. Podsumowanie: Dotychczasowe doniesienia pozwalają stwierdzić, że PIMS jest rzadką, aczkolwiek poważną chorobą dotykającą dzieci najczęściej w wieku szkolnym. Objawy występujące w jej przebiegu nie są swoiste i mogą być różne u każdego pacjenta. Rozpoznanie choroby jest trudne, dlatego opracowano kryteria obejmujące najczęściej występujące objawy, a także powiązanie z ekspozycja na wirusa SARS-CoV-2. Słowa klucz: PIMS symptoms; MIS-C manifestations; hyperinflammation; post-COVID &nbsp

Complications after SARS-CoV2 virus infection in the respiratory, cardiovascular, nervous systems and in the kidneys.

Introduction and objective: The mechanism by which the sars-cov-2 virus attacks organs and causes their long-term complications is not yet fully understood. Many patients who have had COVID-19 complain of various ailments more and more often, and some of them are admitted to hospitals as an emergency. The aim of the study is to present the most common complications after sars-cov-2  infection in selected systems and organs, as well as their consequences. Review methods: In February 2022, the Medline (PubMed) and Google Scholar databases were searched using the following keywords: after COVID-19 complications, long-term sequelae of covid-19, mortality after covid-19, post-covid, long covid . Works in English, French and German published in 2020-2022 were selected. Brief description of the state of knowledge: Accumulated statistics show that COVID-19 very often leaves fibrotic changes in the lungs and nonspecific symptoms such as shortness of breath, persistent headache and loss of taste and smell. Symptoms of right ventricular failure and heart attacks of various etiologies are often observed, and vascular endothelium activated by infection can lead to thrombotic disorders in the lungs, brain and peripheral vascular systems. There was also an increase in the incidence of acute kidney injury during the pandemic. Summary: The reports so far allow to state that the disease process associated with covid-19 does not stop once the main symptoms resolve.Inflammatory changes in the body can continue for a long time and can lead to irreversible complications, sometimes with catastrophic consequences.Wprowadzenie i cel pracy: Mechanizm w jaki wirus sars-cov-2 atakuje narządy i powoduje ich długotrwałe powikłania nie jest do końca poznany. Wielu pacjentów, którzy przebyli COVID-19 coraz częściej skarży się na różne dolegliwości, a część z nich przyjmowana jest do szpitali trybie pilnym. Celem pracy jest przybliżenie najczęściej występujących komplikacji po infekcji sars-cov-2  w wybranych układach i narządach, a także ich następstw. Materiał i metoda: W lutym 2022 roku przeszukano bazy danych Medline (PubMed) oraz Google Scholar przy użyciu słów kluczowych: after COVID-19 complications, long-term sequelae of covid-19, mortality after covid-19, post-covid, long covid . Zostały wybrane prace w językach angielskim, francuskim i niemieckim opublikowane w latach 2020-2022. Opis stanu wiedzy: Zgromadzone statystyki pokazują, że COVID-19 bardzo często pozostawia zmiany zwłóknieniowe w płucach oraz niespecyficzne objawy takie jak duszność, utrzymujący się ból głowy czy utrata smaku i węchu. Często obserwuje się symptomy niewydolności prawej komory serca i zawały serca różnej etiologii, a aktywowany zakażeniem śródbłonek naczyń może prowadzić do zaburzeń zakrzepowych w płucach, mózgu i w obwodowym układzie naczyniowym. Podczas pandemii zanotowano także wzrost ilości przypadków ostrego uszkodzenia nerek. Podsumowanie: Dotychczasowe doniesienia pozwalają stwierdzić, że proces chorobowy związany z covid-19 nie kończy się w momencie ustąpienia głównych objawów. W organizmie zmiany zapalne mogą toczyć się jeszcze długi czas i prowadzić do nieodwracalnych powikłań, niekiedy katastrofalnych w skutkach. Słowa klucz: after covid complications; long-term sequelae of covid-19; mortality after covid-19; post-covid; long covi

Instability of 2,2-di(pyridin-2-yl)acetic acid. Tautomerization versus decarboxylation

The DFT calculations at the B3LYP level with 6-311G** basis set were carried out in order to reveal whether tautomerization or decarboxylation is responsible for the instability of 2,2-di(pyridin-2-yl)acetic (DPA) and 1,8-diazafluorene-9-carboxylic (DAF) acids. The carboxyl protons in both compounds are involved in the intramolecular hydrogen bonds (the pyridine nitrogen atoms are the hydrogen bond acceptors). Although formation of two intramolecular OH···N hydrogen bonds in the enols of both carboxylic acids enables effective electron delocalization within the quasi rings (···HO − C = C − C = N), only ene-1,1-diol of DAF has somewhat lower energy than DAF itself (ΔE is ca. 7 kcal mol-1). DPA and its enediol have comparable energies. Migration of the methine proton toward the carbonyl oxygen atom (to form enediols) requires overstepping the energy barriers of 55-57 kcal mol-1 for both DPA and DAF. The enaminone tautomers of the acids, formed by migration of this proton toward the pyridine nitrogen atom, are thermodynamically somewhat more stable than the respective enediols. The energy barriers of these processes are equal to ca. 44 and 62 kcal mol-1 for DPA and DAF, respectively. Thus, such tautomerization of the acids is not likely to proceed. On the other hand, the distinct energetic effects (ca. 15 kcal mol-1) favor decarboxylation. This process involves formation of (E)-2-(pyridin-2(1H)-ylidenemethyl)pyridine and its cyclic analogue followed by their tautomerization to (dipyridin-2-yl)methane and 1,8-diazafluorene, respectively. Although the later compound was found to be somewhat thermodynamically more stable, kinetic control of tautomerization of the former is more distinct

Measles: A disease that’s making a comeback

Introduction: Measles is a highly contagious viral disease that occurs around the world, featured by fever and the characteristic maculopapular rash, which can also be associated with cough, conjunctivitis or coryza. In recent years, there has been an alarming increase in the amount of measles cases in many countries around the world. The aim of this study is to review the literature and systematize knowledge about measles.Brief description of the state of knowledge: The disease is caused by the measles virus, which is highly infectious, and its only reservoir is humans. The infection occurs via droplets, and the disease is a three-phase course. Unfortunately, measles is behind multiple complications, which may lead to death. In view of no specific antiviral therapies available for the treatment of measles, controlling the spread of the disease depends on prophylaxis, that is the use of widely available and effective vaccination against measles. Despite the presence of vaccines, there is still a substantial risk of further endemic outbreaks.  Conclusions: Nowadays, the elimination of measles is a major challenge due to increasing population density, ongoing wars, pandemics and other social and political factors. Hence, it remains paramount to make every effort to increase the quantity of people vaccinated against measles and to control its spread globally

Selected effects of combined oral contraceptives use

Introduction and objective:: Combined oral contraceptives (COCs) are one of the most popular methods of contraception worldwide. The universality of this method leads to the constant analysis of its influence on the female body. The purpose of this study is to discuss selected side effects of COC use. Review methods: In July 2022, articles found in the Medline (Pubmed) and Google Scholar databases were selected by using the following keywords: oral contraceptive use; risk of cancer; depression; side effects of hormonal contraception; venous thrombosis. Brief description of the state of knowledge: COC use has been shown to be associated with a 2-6 fold increase in the risk of developing venous thromboembolism (VTE). The component responsible for this side effect was initially thought to be synthetic estrogen - ethinylestradiol. It is now recognized as having the greatest influence on mood disorders. An increased risk of cancer has been reported in women taking COCs in case of breast cancer and liver cancer. Inverse relationship was observed in colorectal cancer, ovarian cancer and endometrial cancer. Summary: COC use can have side effects, but it also has many health benefits. Therefore, it is important to constantly learn about this topic and minimize the risk of adverse side effects

The effectiveness of negative pressure wound therapy compared to the traditional method in the treatment of diabetic foot

Introduction and objective: Diabetes is one of the most common metabolic diseases in the world. Diabetic foot ulcers, which are often the result of the disease, are undoubtedly a nursing challenge. Negative pressure wound therapy (NPWT) is a new therapeutic method supporting wound healing, which has been useful in patients with diabetic foot. The purpose of this study is to compare the effectiveness of negative pressure therapy in comparison to the standard method in the treatment of diabetic foot. Review methods: In February 2023, articles found in the Medline (Pubmed) and Google Scholar databases were selected by using the following keywords: negative pressure wound therapy; VAC therapy; traditional dressing; standard moist wound care; diabetic foot. Brief description of the state of knowledge: NPWT has been proven to be associated with reduced healing time and faster appearance of granulation tissue, which is a sign of wound healing. Patients using this method require fewer dressing changes and surgical cleanings. Negative pressure therapy reduces the time to rehospitalisation and  the risk of amputation or resection of the diabetic foot. Summary: Negative pressure wound therapy is more effective in the treatment of diabetic foot ulcers than traditional therapy. Despite the costs associated with NPWT being higher, the method proves to be more profitable. It is important to remember about good therapy technique and proper selection of patients

The tasks of community nurse related to the needs of older people based on results of focus groups research conducted as a part of the European project PROGRESS : "Improving access to community-based services for older people in their households"

Current demographic trends show that the process of aging in Europe and Poland is still going on. This cause a growing demand for medical services and social services. The older people are the main beneficiaries of health care, especially of the nursing and care system, which entails the reorganizing the system of care for the seniors in their households. The aim of this study is to define new tasks for the community nurse drawing from the needs and expectations of the older people. The two focused groups interviews conducted in the framework of the project "Improving access to communitybased services for older people in their households" consisted of 6 older people and 11 representatives of various community care providers. Older people's expectations focused on various community institutions are mostly addressed to community nurses. Participants of two focus groups emphasize the important role of community nurse in the process of informing senior citizens about the possibilities of obtaining care and the tasks of nurses in transmitting information to other community professionals of geriatric team. In community nurse’s work apart from performing instrumental tasks it is particularly important to provide informational and emotional support for older people and their families. It is necessary to define the new tasks of nurse in caring for the older people

Identifying of elderly abuse by community nurses

Elderly abuse (including all forms like: physical, psychological, financial, abandonment and neglect), has been grown as a social problem in Polish society. Being involved in giving home care by community nurses give them ability to recognize the first signs of elderly abuse and to perform coping strategy in the face of recognized incidents. The aim of this research was to compare perception of different forms of elderly abuse by community and clinical nurses, and investigate its determinants. The study sample consisted of 67 community nurses and 117 clinical nurses. The research tool was the original questionnaire developed by research team of the Department of Medical Sociology at Jagiellonian University Medical College in Krakow. Statistical analysis was performed using logistic regression model with use of IBM SPSS 19 for Windows. Analysis of results showed that neglect and self-neglect have been reported as a serious problem in everyday care less frequently by community nurses than by clinical nurses. They also more rarely recognized abandonment as a social problem in Poland. Risk of perception of an emotional abuse as a social problem in Poland associated with was significantly lower in nurses aged 40 years and over, whose professional career lasted longer than 20 years. Risk of assessment that neglect of older persons accompanied them in everyday care was supported by nurses with university education. Community nurses should receive special professional training in recognizing the elderly abuse

The tasks of community nurse related to the needs of older people based on results of focus groups research conducted as a part of the European project PROGRESS: „Improving access to community-based services for older people in their households”

Wstęp. Współczesne trendy demograficzne pokazują, że proces starzenia się ludności w wielu krajach europejskich nadal trwa; wysoki stopień starości demograficznej dotyczy również Polski. Powoduje to wzrost zapotrzebowania na usługi medyczne i socjalne. Osoby starsze są głównymi beneficjentami opieki zdrowotnej w zakresie świadczeń pielęgniarskich i opiekuńczych, co wymusza konieczność reorganizacji systemu opieki nad osobami starszymi w środowisku zamieszkania. Cel badania. Celem badania było wskazanie zadań dla pielęgniarki środowiskowej wyznaczonych przez potrzeby i oczekiwania podopiecznych w starszym wieku. Materiał i metody. W dwóch zogniskowanych wywiadach grupowych przeprowadzonych w ramach projektu „Zwiększenie dostępu do środowiskowych form opieki dla osób starszych, mieszkających we własnych gospodarstwach domowych” wzięło udział 6 osób starszych oraz 11 przedstawicieli różnych usługodawców opieki środowiskowej. Wyniki. Oczekiwania ludzi starszych wobec różnych instytucji środowiskowych w głównej mierze są adresowane do pielęgniarek środowiskowych. Uczestnicy grup fokusowych podkreślają znaczenie pielęgniarki środowiskowej w procesie informowania seniorów o możliwościach uzyskania opieki. Wskazują również na rolę pielęgniarki w przekazywaniu informacji innym profesjonalistom środowiskowego zespołu geriatrycznego. Szczególnie istotne w realizowanych przez pielęgniarkę środowiskową zadaniach, obok wykonywania czynności instrumentalnych, jest udzielanie wsparcia informacyjnego oraz emocjonalnego seniorowi i jego rodzinie. Wnioski. W świetle obserwowanych zmian demograficznych wzrost zapotrzebowania ludzi starszych na świadczenia pielęgnacyjno-opiekuńcze wymusza organizowanie środowiskowej opieki pielęgniarskiej opartej na potrzebach i oczekiwaniach jej odbiorców. Problemy Pielęgniarstwa 2011; 19 (2): 239–243Introduction. Current demographic trends show that the process of aging in Europe and Poland is still going on. This cause a growing demand for medical services and social services. The older people are the main beneficiaries of health care, especially of the nursing and care system, which entails the reorganizing the system of care for the seniors in their households. Aim of the study. The aim of this study is to define new tasks for the community nurse drawing from the needs and expectations of the older people. Material and methods. The two focused groups interviews conducted in the framework of the project „Improving access to communitybased services for older people in their households” consisted of 6 older people and 11 representatives of various community care providers. Results. Older people’s expectations focused on various community institutions are mostly addressed to community nurses. Participants of two focus groups emphasize the important role of community nurse in the process of informing senior citizens about the possibilities of obtaining care and the tasks of nurses in transmitting information to other community professionals of geriatric team. In community nurse’s work apart from performing instrumental tasks it is particularly important to provide informational and emotional support for older people and their families. Conclusions. It is necessary to define the new tasks of nurse in caring for the older people. Nursing Topics 2011; 19 (2): 239–24