Neuropathic alterations of the myenteric plexus neurons following subacute intraperitoneal administration of salsolinol

Introduction. Impairment of the enteric nervous system has been suggested to occur within the pathogenesis of neurodegenerative diseases. Thus, in the current study, we consider salsolinol (1-methyl-6,7-dihydroxy-1,2,3,4-tetrahydroisoquinoline, SAL) as a substance that can potentially induce myenteric neurodegen­eration. Material and methods. Male Wistar rats were subjected to continuous intraperitoneal dosing of salsolinol (200 mg/kg in total) with osmotic mini-pumps for either two or four weeks. An equivalent group of rats served as the control. Jejunal myenteric neurons were subjected to immunofluorescence staining to detect neuron specific protein — protein gene product (pan-neuronal marker, PGP 9.5), nitric oxide synthase (NOS), choline acetyltransferase (ChAT), Bax-protein and alpha-synuclein. In search of any functional impairment within the gastrointestinal tract, gut motility was assessed by determining the residual solid food contents in the stomach and the small and large intestine transit. Results. The myenteric neuron count, the mean size of the neuron body, the area of ganglia and the diameter of nerve strands were decreased in both of the salsolinol-treated groups compared with the controls. The number of NOS-positive cells was lower in the salsolinol-treated groups, while the number of ChAT-positive cells remained unchanged in comparison with the controls. Neurons expressing the pro-apoptotic Bax protein and alpha-synuclein deposits were observed among the myenteric neurons of the salsolinol-treated rats. Conclusions. Salsolinol evokes enteric neuronal cell death via initiation of apoptosis and leads to the formation of pathological aggregates of alpha-synuclein. Impairment of myenteric neurons, mainly the inhibitory motor neurons, might be responsible for the abnormal intestinal transit. Thus, salsolinol might be regarded as a suitable compound for inducing experimental enteric neurodegeneration in rats

Telocytes : new insight into the pathogenesis of gallstone disease

The major mechanisms of gallstone formation include biliary cholesterol hypersecretion, supersaturation and crystallization, mucus hypersecretion, gel formation and bile stasis. Gallbladder hypomotility seems to be a key event that triggers the precipitation of cholesterol microcrystals from supersaturated lithogenic bile. Telocytes, a new type of interstitial cells, have been recently identified in many organs, including gallbladder. Considering telocyte functions, it is presumed that these cells might be involved in the signalling processes. The purpose of this study was to correlate the quantity of telocytes in the gallbladder with the lithogenicity of bile. Gallbladder specimens were collected from 24 patients who underwent elective laparoscopic cholecystectomy for symptomatic gallstone disease. The control group consisted of 25 consecutive patients who received elective treatment for pancreatic head tumours. Telocytes were visualized in paraffin sections of gallbladders with double immunofluorescence using primary antibodies against c‐Kit (anti‐CD117) and anti‐mast cell tryptase. Cholesterol, phospholipid and bile acid levels were measured in gallbladder bile. The number of telocytes in the gallbladder wall was significantly lower in the study group than that in the control group (3.03 ± 1.43 versus 6.34 ± 1.66 cell/field of view in the muscularis propria, P < 0.001) and correlated with a significant increase in the cholesterol saturation index. The glycocholic and taurocholic acid levels were significantly elevated in the control subjects compared with the study group. The results suggest that bile composition may play an important role in the reduction in telocytes density in the gallbladder

Factors affecting Polish nurses' willingness to recommend the hospital as a place of care

Background: Nurses constitute the major professional group offering constant hospital patients’ care. Willingness to recommend their hospital reflects confidence in the offered care, satisfaction and identification with the work place. The aim of the present study has been to investigate which elements of hospital environment and nurse personal related factors predict recommendation of the hospital as a place of care by employed nurses. Material and Methods: Cross-sectional, correlation study was, based on 1723 self-reported, anonymous questionnaires of nurses working in 30 acute hospitals. Data was analyzed using the logistic regression model, with general estimation equations. Results: About 25% of nurses were unwilling to recommend their hospital as the place of care. The odds ratio (OR) of the lack of willingness to recommend the hospital was related to assessment of patients’ safety (OR = 0.28, 95% confidence interval (CI): 0.18–0.46, p = 0.00), decrease in the quality of patient care during the preceding year (OR = 0.62, 95% CI: 0.41–0.93, p = 0.02), overall work conditions (OR = 0.35, 95% CI: 0.22–0.57, p = 0.00), weak cooperation between nurses and physicians (OR = 0.37, 95% CI: 0.25–0.54, p = 0.00), poor work schedule flexibility (OR = 0.74, 95% CI: 0.55– 0.99, p = 0.04) and educational opportunities (OR = 0.71, 95% CI: 0.54–0.95, p = 0.02) and the level of nurses depersonalization (OR = 1.78, 95% CI: 1.18–1.68, p = 0.00). Conclusions: The hospital manager should consider strategies which improve patients’ safety and the staff working conditions. Thanks to that they will also achieve better and more competitive image of the hospital in the local community. Med Pr 2016;67(4):447–45

Organizacja i zakres badań RN4CAST (Registered Nurse Forecasting) dotyczących planowania zatrudnienia w pielęgniarstwie w Polsce

Forecasting nursing. Planning human resources in nursing, organisation and scope of the RN4CAST study in Poland The study was conducted as part of European RN4CAST project, with participation of 16 countries, including 12 from Europe. Aim: To develop universal and modern assumptions for the policy of effective nurse employment and management in hospital. Material and method: The study was conducted on a nationally representative sample of 30 hospitals, selected through multi-stage group sampling. Professional satisfactions of nurses working at internal and surgical wards, as well as satisfaction of patients of these wards were tested in a questionnaire study. Data on patient treatment outcomes, and hospital organisation and operation were also collected. Hierarchical linear modelling (HLM) and generalised estimating equations (GEE) were used for statistical analysis. Conclusion: RN4CAST is the first project focused on the hospital and contextual determinants of its operation, which compares Polish results with those from other European states, thanks to a single international study procedure

Organization and the scope of the RN4CAST (Registered Nurse Forecasting) study concerning planning of nursing workforce in Poland

The study was conducted as part of European RN4CAST project, with participation of 16 countries, including 12 from Europe. Aim: To develop universal and modern assumptions for the policy of effective nurse employment and management in hospital. Material and method: The study was conducted on a nationally representative sample of 30 hospitals, selected through multi-stage group sampling. Professional satisfactions of nurses working at internal and surgical wards, as well as satisfaction of patients of these wards were tested in a questionnaire study. Data on patient treatment outcomes, and hospital organisation and operation were also collected. Hierarchical linear modelling (HLM) and generalised estimating equations (GEE) were used for statistical analysis. Conclusion: RN4CAST is the first project focused on the hospital and contextual determinants of its operation, which compares Polish results with those from other European states, thanks to a single international study procedure

Interplay of nitric oxide metabolites and markers of endothelial injury, inflammation and vascular disease in the spectrum of advanced chronic kidney disease

Background: Chronic kidney disease is linked to cardiovascular morbidity; therefore, relevant biomarkers are widely investigated. Aims: We aimed to assess the relationship between nitric oxide (as measured by its metabolites, NOx), a key endothelial molecule, with markers of endothelial dysfunction, inflammation, antioxidant status, and mineral disorders as well as histologically assessed vascular calcification in uremic and hemodialysis patients with chronic kidney disease. Methods: Plasma and serum samples were obtained from 62 patients with renal failure. NOx was assessed by the Griess method, while the other biomarkers were measured by the immunoenzymatic assay. Morphological analysis of arterial calcification was performed in a blinded, semiquantitative manner. Common carotid intima‑media thickness and atherosclerotic plaques were assessed by ultrasonography. Results: In the simple analysis, NOx levels correlated positively with the parameters of renal function, mineral metabolism, endothelial injury, and inflammation. NOx predicted carotid intima‑media thickness in simple (P = 0.014) and multiple analysis (P = 0.036) adjusted for the Framingham risk score, C‑reactive protein, serum creatinine, and parathormone. The occurrence of atherosclerotic plaques in the common carotid artery was correlated with higher NOx concentrations (P = 0.021). Conclusions: In chronic renal failure, NOx is associated with surrogate markers of atherosclerosis, even after adjustment for traditional cardiovascular risk factors, inflammation, and renal function, but not with the presence or grade of medial arterial calcification. Endothelial injury, inflammation, and mineral metabolism markers are associated with NOx levels, though a causal link requires further study

Selected factors determining assessment of nursing care quality in acute hospitals : results of RN4CAST project

Introduction. The essence of nursing care is to improve treatment results, patient satisfaction, and decrease treatment costs. Aim. Presenting the factors determining the assessment of nursing care quality in acute hospitals. Material and method. The study included 2605 nurses working in 30 hospitals in Poland. The Work Environment Scale and an opinion questionnaire were used to collect the data. The analysis based on logistic regression model, generalised estimating equations, χ² test, and Mann-Whitney test. Results. Three in every four respondents evaluated the quality of nursing care as good. The assessment depended on the conditions of work, autonomy in providing care, patient information flow, patient safety, occurrence of adverse events, discussion of mistakes, nurse workload, potential for education, and flexible working time. Conclusion. The factors significantly influencing the assessment of nursing care quality are the working environment, care monitoring and management

Factors influencing recommendation of a hospital as place of employment in the opinion of nurses working in Polish hospitals

Introduction. European states observe an increased demand for healthcare services and diminishing numbers of nurses working in the healthcare system. A divergence that may result in future shortages of hospital nursing staff. Aim. Definition of factors that influence readiness to recommend the hospital as place of employment by nurses employed in Polish hospitals. Material and method. Polish part of the RN4CAST protocol, the study uses logistic regression model on data from 2605 questioners from nurses working in 30 Polish hospitals. Results. About half of the responders declared readiness to recommend employment in their hospital. The recommendation depended on working conditions, quality of care, patient safety, and manager interest in professional development of personnel. Higher level of emotional burnout reduced the probability of recommendation. Conclusions. Working conditions, quality of care, patient safety, and potential of professional development are the main factors deciding about the eagerness to recommend employment in one’s hospital