Refusal to grant a vote of confidence to the municipal executive body - a procedural aspect

The subject of the publication is the activity of the resolution-maker of executive bodies. From 2018, a new procedure was introduced into the legal system regarding resolutions of constitutive bodies of local government units, i.e. the emergence of resolutions by operation of law as a legal fiction and a consequence of a different action. Both the new mode of drawing up the resolutions and the legal form of the failure to grant a vote of confidence to the executive body of the commune are important. The legal form of expressing the will to refuse to grant a vote of confidence by a decision-making body is a resolution. This resolution is adopted in a special mode - without voting - and has a special character, for its validity it is necessary to justify constituting a formal part of the resolution. Therefore, the legal views presented by the supervisory authorities over the self-government, shaping the administrative practice of self-government bodies, do not find legal justification both in the act on commune self-government and in the jurisprudence practice.Przedmiotem publikacji jest działalność uchwałodwacza organów wykonawczych. Od 2018 r. wprowadzono do systemu prawnego nową procedurę dotyczącą uchwał organów stanowiących jednostek samorządu terytorialnego, tj. pojawienie się uchwał z mocy prawa jako fikcja prawna i konsekwencja innego działania. Istotny jest zarówno nowy tryb powstania uchwał, jak i forma prawna nieudzielenia wotum zaufania organowi wykonawczemu gminy. Formą prawną wyrażenia woli odmowy udzielenia wotum zaufania przez organ stanowiący jest uchwała. Uchwała ta jest podejmowana w trybie szczególnym – bez głosowania – i ma szczególny charakter, dla jej ważności niezbędne jest uzasadnienie stanowiące część formalną uchwały. Dlatego też poglądy prawne prezentowane przez organy nadzorcze nad  samorządem, kształtujące praktykę administracyjną organów samorządu, nie znajdują uzasadnienia prawnego zarówno w ustawie o samorządzie gminnym, jak iw praktyce orzeczniczej

Multiple sclerosis: oral health, behaviours and limitations of daily oral hygiene — a questionnaire study

Clinical rationale for the study. Neurological deficits and progressing disability in patients with multiple sclerosis (MS) may hamper daily oral hygiene, but their relations with oral problems have not yet been clearly determined.Aim of the study. The aim of this study was to identify the most significant dental problems and limitations of daily oral hygiene in Polish patients with MS.Material and methods. 199 patients with diagnosed MS (median age 37 years) treated in the neurological outpatient clinic were interviewed using a paper-based questionnaire. They provided answers on oral health, behaviours and the limitations of their daily oral hygiene. Clinical information regarding symptoms, MS phenotype, relapses, medication and degrees of disability was based on medical records.Results. The most frequent symptoms were dry mouth (43.2%) and bleeding from gums (28.1%). Dry mouth was more frequent in patients with secondary-progressive MS (SPMS) than relapsing-remitting MS (65.4% vs 41.3%, p = 0.023). Patients with bleeding from gums had had MS for a longer duration (median 6 vs 4 years, p = 0.002). Difficulties in daily oral hygiene were more frequent in patients with SPMS (24.0% vs 8.1%; p = 0.016). Greater proportions of patients with muscle weakness of limbs, imbalance or pain brushed their teeth irregularly. Frequent (i.e. at least every six months) visits to the dentist’s surgery were uncommon in patients with SPMS (12.0% vs 39.7%, p = 0.010).Conclusions and clinical implications. Dry mouth and bleeding from gums are more frequent in patients with longer lasting and more advanced types of MS. Daily oral hygiene and oral health self-control is limited in patients with MS, mainly due to motor deficits, balance problems and pain, and this becomes worse with disease duration. To minimise the burden of the disease, patients with MS require better education and improvement in their awareness regarding proper oral health control, such as the use of electric toothbrushes. In addition, patients with chronic and progressive disability from multiple sclerosis may benefit from better organised access to dental care

What you cannot get from routine MRI of MS patient and why – The growing need for atrophy assessment and seeing beyond the plaque

Multiple sclerosis is a disease that still has not been fully understood and calls for better diagnostic procedures for the improvement of everyday patient care and drug development. Routine magnetic resonance examinations reveal demyelinating focal lesions, but they do not correlate sufficiently with the patients’ disability and cognitive impairment. For more than 100 years it has been known that demyelination affects not only white but also grey matter of the brain. Recent research has confirmed the serious consequences of grey matter pathology. Over the last several years, atrophy of the brain and especially of its grey matter has become a most promising marker of the patients’ clinical status. The paper discusses the concept and importance of atrophy assessment in relation to the standard magnetic resonance results

Polish Respiratory Society Guidelines for Chronic Obstructive Pulmonary Disease

Pierwsze krajowe “Zalecenia postępowania w przewlekłej obturacyjnej chorobie płuc (POChP)” powstały w 1998 roku z inicjatywy profesorów Jana Zielińskiego i Józefa Małolepszego oraz dr. hab [...

Zalecenia Polskiego Towarzystwa Chorób Płuc dotyczące rozpoznawania i leczenia przewlekłej obturacyjnej choroby płuc (POChP)

Pierwsze krajowe Zalecenia Postępowania w Przewlekłej Obturacyjnej Chorobie Płuc (POChP) powstały w 1998 roku z inicjatywy Profesorów Jana Zielińskiego i Józefa Małolepszego oraz Doktora hab [...

Lung-heart clinical crosstalk in the course of COPD exacerbation

 Wstęp: Zaostrzenie POChP jest stanem zagrożenia życia, któremu towarzyszy duszność wtórna do przeciążenia układów oddechowego i/lub krążenia. Jak dotąd w pojedynczym badaniu nie określono istotności klinicznej zmian hiperinflacji, obturacji i wydolności układu krążenia w przebiegu leczenia zaostrzenia POChP. Celem badania była ocena wpływu leczenia zaostrzenia POChP na nasilenie obturacji oskrzeli, rozdęcia płuc, oraz na zmianę stanu hemodynamicznego chorych leczonych z powodu zaostrzenia POChP.Materiał i metody: Do badania włączono 40 pacjentów w wieku 67 ± 8 lat (90% mężczyzn) hospitalizowanych z powodu zaostrzenia POChP. Chorych badano przed i po zakończeniu leczenia z zastosowaniem: badań czynnościowych układu oddechowego, echokardiografii przezklatkowej, sześciominutowego testu marszowego, stężeń Endoteliny-1 i NT-proBNP w surowicy krwi oraz skali mMRC.Wyniki: W trakcie leczenia zaobserwowano istotne zmniejszenie rozdęcia płuc: przed-RV%TLC: 64,3 ± 9,0; po-RV%TLC 60,6 ± 11,1; p = 0,03;, zmniejszenie obturacji FEV1[L] przed FEV1: 1,0 ± 0,4, po-FEV1: 1,2 ± 0,5; p < 0,001; oraz obniżenie średniego ciśnienia w tętnicy płucnej (PAPmean) [mm Hg]: przed-PAPmean: 41,2 ± 11,2; po-PAPmean: 39,1 ± 12,1; p = 0,029. Zaobserwowano trend do zmniejszenia skurczowego ciśnienia w prawej komorze serca (RVSP) [mm Hg]: przed-RVSP: 44,5 ± 12,9; po-RVSP: 36,3 ± 14,3; p = 0,068 oraz stężenia ET-1 [fmol/ml]: przed- ET-1: 1,7 ± 2,8; po-ET-1: 1,3 ± 1,9; p = 0,076, lecz nie NT-proBNP. Zaobserwowano wydłużenie dystansu 6MWT: przed: 294 ± 132; po-leczeniu: 415 ± 102; p < 0.001; oraz zmniejszenie duszności: przed-MRC: 3,3 ± 0,8; po-MRC: 1,8 ± 0,9; [pkt.] p < 0,001. Dystans 6MWT i wynik testu MRC korelowały z RV%TLC (p < 0,05; odpowiednio r = –0,58; r = 0,51), lecz nie z RVSP czy PAPmean.Wnioski: W trakcie leczenia zaostrzenia POChP obserwuje się zmniejszenie rozdęcia płuc i obturacji oskrzeli. Koreluje to ze zmniejszeniem duszności i poprawą wydolności wysiłkowej. Zaobserwowane w trakcie leczenia obniżenie mPAP nie koreluje z wydłużeniem dystansu 6MWT czy nasileniem duszności mierzonym za pomocą skali mMRC. Introduction: COPD exacerbation is a life-threatening condition with acute dyspnoea caused by respiratory or circulatory distress. The significance and co-presence of lung hyperinflation, bronchial obstruction, and changes in haemodynamics in the course of COPD exacerbation treatment have not been well described yet in course of a single study. Our aim was to evaluate the influence of COPD exacerbation treatment on bronchial obstruction, pulmonary hyperinflation, and possible changes of right and left ventricle haemodynamics in relation to the patient’s clinical status.Material and methods: A total of 40 patients (90% males), 67 ± 8 years old, with COPD were assessed pre- and post-exacerbation treatment by the following: respiratory function tests, transthoracic echocardiography, 6MWT, endothelin-1 (ET-1) and NT-proBNP serum concentrations, and MRC scale.Results: A significant decrease in RV%TLC (%) and mean pulmonary artery pressure (PAPmean) [mm Hg] was observed: pre -RV%TLC: 64.3 ± 9.0; post-RV%TLC 60.6 ± 11.1; p = 0.03; pre-PAPmean: 41.2 ± 11.2; post-PAPmean: 39.1 ± 12.1; p = 0.029, coupled with a significant increase of FEV1 [L]-preFEV1: 1.0 ± 0.4, post-FEV1: 1.2 ± 0.5; p < 0.001. A trend for reduced right ventricle systolic pressure (RVSP) [mm Hg]: pre-treatment: 44.5 ± 12.9; post-treatment: 36.3 ± 14.3; p = 0.068 and ET-1 [fmol/ml]: pre-treatment: 1.7 ± 2.8; post-treatment: 1.3 ± 1.9; p = 0.076, but not for NT-proBNP was noticed. Improvement of both, 6MWT [m]: pre-treatment: 294 ± 132; post-treatment: 415 ± 102; p < 0.001 and MRC [pts.]: pre-treatment: 3.3 ± 0.8; post-treatment: 1.8 ± 0.9; p < 0.001, were noticed. 6MWT correlated with RV%TLC (p < 0.05; r = –0.46; r = –0.53; respectively) and FEV1 (p < 0.05; r = 0.55; r = 0.60, respectively) on admission as well as on discharge. There was no such correlation with RVSP or PAPmean.Conclusions: Pulmonary hyperinflation and bronchial obstruction may be reduced by effective COPD exacerbation treatment and are accompanied by clinical improvement. The mPAP reduction observed in the course of treatment was not correlated with the results of 6MWT and MRC score

Hepatic tissue changes in rats due to chronic invasion of Babesia microti

The etiological agents of babesiosis are intraerythrocytic parasites of the genus Babesia, which are transmitted by ticks. The course of disease is characterized by variable severity. The risk of a complicated course of babesiosis occurs in premature infants, the elderly, splenectomized patients and other immunocompromised patients. Severe cases of this disease can lead to multiple organ dysfunction. The study focuses on the impact assessment of chronic Babesia microti invasion on the morphology and ultrastructure of rat liver. The analyzed material was comprised of liver samples collected from Wistar rats infected with a reference strain of B. microti (ATCC 30221). None of the livers collected from rats with babesiosis was enlarged. The histopathological analyses showed signs of intensive inflammatory processes, especially in the perivascular areas. The hepatic mononuclear phagocyte system was characterized by increased activity. The ultrastructral analyses confirmed disintegration of hepatocytes with vacuolization in the perivascular areas. In addition, the perisinusoidal space (space of Disse) had irregular structure. In some areas, the space of Disse was enlarged or compressed. The morphological and ultrastructural analyses of rat liver with chronic babesiosis caused by B. microti showed significant pathological changes in perivascular areas which may be the cause of hepatic dysfunction

Seasonal activity of urban bats populations in temperate climate zone – a case study from Southern Poland

Municipal greenery can mitigate the negative impact of urbanization on biodiversity, including bats, by providing a migration corridor, food base and roosts. Our study aimed to evaluate the species composition and diversity, test the differences in activity between seasons, and identify the atmospheric conditions influencing the bats’ activity in the Planty Park (Cracow). Fieldworks were conducted in 2016 and 2017. We recorded 10 species, two new for this part of Poland: the Kuhl’s pipistrelle (Pipistrellus kuhlii) and the Savi’s pipistrelle (Hypsugo savii). Taxa were divided into three ecological guilds. Myotis group’s activity was insufficient to perform statistical analyses. The activity of Nyctalus, Eptesicus and Vespertilio group peaked in late summer. A similar insignificant trend was observed for Pipistrellus and Hypsugo. Temperature enhanced the activity of Nyctalus, Eptesicus and Vespertilio group in spring and early summer, while cloud cover suppressed their activity in autumn. Temperature also enhanced Pipistrellus and Hypsugo group activity in spring and autumn, but it suppressed their summer activity. Our study is one of the first to investigate temperate urban bats’ phenology and may serve as a preface for further research to introduce detailed urban landscape planning recommendations

Usefulness of induced sputum in the diagnostics of selected chronic inflammatory airway diseases

Introduction: Based on the normal values for inflammatory cell counts in induced sputum produced by healthy individuals living in the region of Silesia, Poland, we assessed the usefulness of cytological examination of induced sputum in the diagnostic evaluation of asthma, chronic obstructive pulmonary disease (COPD) and chronic bronchitis. Material and methods: We analyzed the results of examinations performed in 96 healthy individuals (controls), 42 patients with asthma, 49 with COPD and 30 with chronic bronchitis. We performed spirometry with salbutamol reversibility testing and examination of induced sputum in all the subjects. Those without contraindications underwent methacholine challenge testing. Results: We found a significantly elevated percentage of eosinophils in all the patient groups compared to the controls (p < 0.00001). Median values were 10.3% for asthma, 1.5% for COPD, 1.6% for chronic bronchitis and 0.3% for the controls. We found statistically significant differences in the mean neutrophil percentages in induced sputum between healthy individuals and asthma patients, COPD patients and chronic bronchitis patients (p < 0.05). The median values were 45.75%, 38.1%, 77.5% and 58.1%, respectively. The percentage of subjects with positive eosinophil counts (> 2.8%) in the sputum of patients with asthma, COPD, chronic bronchitis and in the controls was 85%, 38%, 20% and 6%, respectively. Conclusions: 1. Cytological examination of induced sputum is a good test supporting the diagnostic evaluation of chronic inflammatory diseases of the respiratory tract. 2. The percentage of eosinophils in induced sputum exceeding 2.8% is a very good indicator of asthma.Wstęp: Na podstawie wyznaczonych wartości prawidłowych dla składu komórek zapalnych w plwocinie indukowanej osób zdrowych zamieszkałych na Śląsku określono przydatność badania cytologicznego plwociny indukowanej w diagnostyce astmy oskrzelowej, przewlekłej obturacyjnej chorobie płuc (POChP) oraz przewlekłego zapalenia oskrzeli (PZO). Materiał i metody: Analizą objęto wyniki badań pochodzące od 96 zdrowych osób (grupa kontrolna), 42 osób chorych na astmę oskrzelową, 49 pacjentów chorych na POChP oraz od 30 osób chorych na PZO. Wszystkim badanym wykonano spirometrię z próbą odwracalności po inhalacji 200 &#956;g salbutamolu, badanie indukowanej plwociny oraz, osobom bez przeciwwskazań, badanie nadreaktywności oskrzeli z metacholiną. Wyniki: Stwierdzono znamiennie podwyższony (p < 0,00001) odsetek eozynofilów we wszystkich badanych grupach chorych w porównaniu z grupą kontrolną. Wartości median wynosiły: dla astmy oskrzelowej - 10,3%, dla POChP - 1,5%, dla PZO - 1,6%, dla grupy kontrolnej - 0,3%. Zauważono istotne statystycznie różnice (p < 0,05) pomiędzy średnimi odsetkami neutrofilów w plwocinie indukowanej osób zdrowych a chorymi na astmę oskrzelową, POChP i PZO. Wartości median wynosiły kolejno: 45,75%; 38,1%; 77,5% i 58,1%. Odsetek chorych z dodatnim wynikiem eozynofilów w plwocinie (> 2,8%) wynosił w grupie chorych na astmę oskrzelową 85%, chorych na POChP - 38%, chorych na PZO - 20%, w grupie kontrolnej - 6%. Wnioski: 1. Badanie cytologiczne indukowanej plwociny jest dobrym testem wspomagającym diagnostykę przewlekłych chorób zapalnych dróg oddechowych. 2. Odsetek eozynofilów w plwocinie indukowanej powyżej 2,8% z dużym prawdopodobieństwem potwierdza rozpoznanie astmy oskrzelowej