Is it worth to continue to analyse the factors of cardiovascular risk among the sailors? Review of literature

Background: Cardiovascular diseases are still the most common cause of death from natural causes among seafarers. The aim of the study was to determine which of the cardiovascular risk factors listed in the current recommendations of the European Society of Cardiology occur among seafarers. Materials and methods: The paper is a review of literature from PubMed Database.  Results: Based on conducted analysis of over 31 papers high prevalence of classic and other cardiovascular risk factors among seafarers was proven. The most common risk factors among off-shore workers are overweight and obesity (over 64%); moreover, these factors occur more often among seafarers than in the general popula- tion. Also hypertension, smoking, type 2 diabetes and unfavourable lipid profile were present more often in this occupational group. In the analysed studies attention was also paid to factors often overlooked in risk assess- ment such as mental and inflammatory illnesses, unfavourable working conditions and psychological burden.  Conclusions: Seafarers have a higher cardiovascular risk because, among other things, the prevalence of “old and new” risk factors among them is higher than in general population.

Przypadki poważnych działań niepożądanych po zastosowaniu farmakoterapii zaburzeń zachowania i snu u dzieci

W pracy przedstawiono przypadki kliniczne 3 chłopców w wieku 6–10 lat, u których wystąpiły ciężkie działania niepożądane po podaniu leków zastosowanych z powodu zaburzeń zachowania i snu. Wskazania do zastosowania farmakoterapii nie były jednoznaczne, a wcześniejsza psychoterapia — zależnie od przypadku — bardzo krótka lub wydawała się niewystarczająca. Pacjenci byli hospitalizowani na Oddziale Interny Dziecięcej Szpitala Dziecięcego POLANKI w Gdańsku między czerwcem a wrześniem 2009 roku. We wszystkich przypadkach, uszeregowanych w pracy stosownie do przebiegu — od najcięższego do najlżejszego, obserwowano powrót do zdrowia. Według dotychczasowej wiedzy autorów, żaden z pacjentów nie wymagał wznowienia farmakoterapii zaburzeń zachowania i snu. Forum Medycyny Rodzinnej 2011, tom 5, nr 5, 424–42

The psychosocial burden and stress coping strategies among seafarers

Background: The seafarers’ professional group is one of the most numerous in the world. According to the statistics of the European Maritime Safety Agency (2020), there are approximately 280,000 people employed at sea in the European Union. The specific work environment on the ship (climatic, physical, chemical, psychological factors, etc.) is related to experiencing long-term stress. The World Health Organization considers work-related stressors to be very important determinants of health and disease. One of the basic psychological resources related to adaptation to demanding working conditions are strategies for coping with stress. The aim of the study is to assess the occurrence of harmful psychosocial factors in the work of seafarers and the stress coping strategies and their relationship with somatic diseases. Materials and methods: One hundred and fifteen seafarers who received a maritime health certificate participated in the study at the Occupational Medicine Clinic. The study was part of a larger project looking at the prevalence of cardiovascular risk factors among seafarers. The study used the Coping Questionnaire in Stressful Situations (CISS) (Endler and Parker) and a general questionnaire created for the purposes of the study. Results: Thirty six per cent respondents were exposed to traumatic event and to having nightmares, 13% had been discriminated at least once in the workplace. A positive correlation was found between discrimination and depression, nightmares and trauma. In addition, people who admitted having experienced trauma slept shorter (also while at home) and experienced nightmares more often. The most common style of coping was task oriented (29; 28.5%), and avoidance oriented (15%). The study also found a positive correlation between depression and the style of emotion-oriented coping and avoidance-oriented coping. Conclusions: The specific working conditions and exposure to traumatic events have a negative impact on the health of seafarers by increasing the risk of depression and cardiovascular diseases. The coping styles with stress depend on the position in the ship hierarchy

Accuracy and Completeness of Drug Information in Wikipedia: A Comparison with Standard Textbooks of Pharmacology

The online resource Wikipedia is increasingly used by students for knowledge acquisition and learning. However, the lack of a formal editorial review and the heterogeneous expertise of contributors often results in skepticism by educators whether Wikipedia should be recommended to students as an information source. In this study we systematically analyzed the accuracy and completeness of drug information in the German and English language versions of Wikipedia in comparison to standard textbooks of pharmacology. In addition, references, revision history and readability were evaluated. Analysis of readability was performed using the Amstad readability index and the Erste Wiener Sachtextformel. The data on indication, mechanism of action, pharmacokinetics, adverse effects and contraindications for 100 curricular drugs were retrieved from standard German textbooks of general pharmacology and compared with the corresponding articles in the German language version of Wikipedia. Quantitative analysis revealed that accuracy of drug information in Wikipedia was 99.7%+/- 0.2% when compared to the textbook data. The overall completeness of drug information in Wikipedia was 83.8 +/- 1.5% (p<0.001). Completeness varied in-between categories, and was lowest in the category "pharmacokinetics'' (68.0% +/- 4.2%;p<0.001) and highest in the category "indication'' (91.3%+/- 2.0%) when compared to the textbook data overlap. Similar results were obtained for the English language version of Wikipedia. Of the drug information missing in Wikipedia, 62.5% was rated as didactically non-relevant in a qualitative re-evaluation study. Drug articles in Wikipedia had an average of 14.6 +/- 1.6 references and 262.8 +/- 37.4 edits performed by 142.7 +/- 17.6 editors. Both Wikipedia and textbooks samples had comparable, low readability. Our study suggests that Wikipedia is an accurate and comprehensive source of drug-related information for undergraduate medical education

The antioxidative-prooxidative balance in children with asthma treated with inhaled corticosteroids and long acting &#946;2-agonists

The aim of study was to analyze the effect of treatment with inhaled corticosteroids and long acting ß2-agonists on antioxidative-prooxidative balance in children with asthma. Material and methods: Twenty children with newly diagnosed asthma before treatment (group I), fourteen children with diagnosed asthma treated with inhaled corticosteroids and long acting &#946;2-agonists and 57 healthy children were ioncluded in the study. In all cases plasma protein carbonyls and activity of erythrocyte SOD was assayed. Results: Plasma protein carbonyls in both group I (1,01 nmol/g of protein, SD=0,30) and group II (0,94; SD=0,15) was significantly higher than in group III (0,85; SD=0,24) (I vs. III

Selected work-related nephropathies

Infections, high temperature and many of the toxic substances can cause kidney damage. Acute kidney injury is a well known complication of some work-related diseases, e.g., lead intoxication. Chronic kidney disease can also be caused by some occupational factors. Three work-related nephropathies, in which causal connection with work has been proved, are discussed in this article. There are different risk factors of nephrolithiasis, lead nephropathy and silica nephropathy, but each of them can cause chronic kidney disease. Prevention of these nephropaties seems to be relatively simple. The principles of protection from the toxic effects of heavy metals and silica dust are very specific. The most important prevention of kidney stones is correct fluid intake. In addition to providing adequate quantities of drinking water, it is also important to educate exposed workers and assure enough rest breaks at work. Med Pr 2015;66(4):583–59

New biochemical markers of ethyl alcohol abuse – new possibilities in clinical practice

Alkohol jest w krajach rozwiniętych jednym z głównych czynników behawioralnych utraty zdrowia i życia. Jego nadużywanie ma poważne skutki społeczne i ekonomiczne: przyczynia się do większej liczby wypadków w pracy, kolizji drogowych oraz nieobecności w zakładach pracy. Rozpoznawanie i leczenie alkoholizmu jest bardzo trudne, dlatego wykorzystanie obiektywnych wskaźników biochemicznych nadużywania alkoholu etylowego może przyczynić się do wcześniejszego rozpoznawania, skuteczniejszego leczenia i wiarygodnego monitorowania okresu abstynencji. Celem pracy jest przedstawienie dostępnych w Polsce czułych i swoistych wskaźników szkodliwego spożywania alkoholu ze szczególnym uwzględnieniem możliwości ich praktycznego wykorzystania. Takie testy mogą znaleźć zastosowanie m.in. w programach odzyskiwania prawa jazdy przez kierowców zatrzymanych z powodu jazdy pod wpływem alkoholu, wczesnego wykrywania osób nadużywających alkoholu wśród pracowników podczas rutynowych badań w zakładach pracy, do monitorowania abstynencji w trakcie leczenia odwykowego, przed planowanymi zabiegami przeszczepiania narządów, do wykrywania szkodliwego spożywania alkoholu wśród kobiet ciężarnych i w sekcjach sądowo-lekarskich. Niezbędna jest standaryzacja metod oznaczania wskaźników w materiale biologicznym, a istotnym problemem we właściwej interpretacji wyników mogą być choroby współistniejące. Mimo tych ograniczeń obiektywne wskaźniki biochemiczne nadużywania alkoholu etylowego mogą być pomocne w opiece nad pacjentami. Szczególną rolę mogą pełnić w diagnostyce w medycynie pracy, przyczyniając się do wzrostu bezpieczeństwa na drogach publicznych oraz bezpieczeństwa pracowników w zakładach pracy.Alcohol ranks as one of the leading behavioral threats to health and life in developed countries. Alcohol abuse triggers serious social and economic effects: it contributes to higher prevalence of work-related and road accidents, as well as absence from work. The diagnosis and treatment of alcoholism still remain very difficult. Hence, the use of objective biochemical markers of alcohol abuse may contribute to earlier detection, more effective therapy and reliable teetotalism control. The aim of this study is to present the sensitive and specific biomarkers of alcohol abuse available in Poland, with particular emphasis on the practical use possibilities. Such tests may be widely used, e.g., in driving license regranting cases involving drivers whose licenses were suspended for driving when intoxicated, for the early detection of persons abusing alcohol in employment-related health controls, for abstinence monitoring during withdrawal treatment, for detecting alcohol consumption in transplant settings, for assessing the prevalence of alcohol drinking in pregnancy, as well as in autopsical examinations. The standardization of biomarkers measurement methods is essential. Moreover, concomitant disorders may pose a significant problem in the proper outcome analysis. Despite these limitations, objective biochemical markers of ethyl alcohol abuse may become helpful tools in medical care. They can play a particular role in occupational medicine diagnostics, contributing to the higher level of safety on public roads and to worker safety

Telemedical Maritime Assistance Service at the University Center of Maritime and Tropical Medicine in Gdynia. The analysis of 6 years of activity

BackgroundIn the 1960s, the International Labour Organization passed a convention under which all countries with national shipping were obliged to create a 24-h telemedicine center for ships. In accordance with the convention, Telemedical Assistance Service centers were to provide permanent access to medical advice given by qualified doctors and to create an international platform for the exchange of information and experience. In Poland, the Telemedical Maritime Assistance Service (TMAS) was established in 2012, and its duties in a 24-h system are carried out by doctors from the University Center of Maritime and Tropical Medicine (UCMTM) in Gdynia. The aim of this work was to determine the reasons for medical officers reporting for help from the TMAS doctor on duty and to create a database of the most common diagnoses and actions undertaken, and in particular evacuation.Material and MethodsIn the presented work, the authors analyzed TMAS telephony and e-mail advice provided by doctors of the UCMTM in Gdynia, in the period from October 2012 to the end of 2018.ResultsIn the 6-year period, UCMTM doctors provided TMAS advice 225 times, recommending evacuation in over 20% of these cases. Infectious diseases were the most common cause of contact in the entire period under analysis – 61 cases were recorded, accounting for as many as 27% of all applications. Injuries were the second most frequent reason for seeking help from TMAS, and 20% of TMAS applications (44 cases) were related to trauma.ConclusionsThe obtained data show that TMAS doctors face various medical problems; therefore, providing proper medical assistance to patients requires a close multidisciplinary cooperation between medical officers, TMAS doctors and emergency services

Immune response against HtrA proteases in children with cutaneous mastocytosis

Mast cells play an important role in both, the innate and adaptive immunity, however, clonal proliferation of abnormal mast cells in various organs leads to mastocytosis. A skin variant of the disease, cutaneous mastocytosis (CM) is the most frequent form of mastocytosis in children. HtrA proteases are modulators of important cellular processes, including cell signaling and apoptosis, and are related to development of several pathologies. The above and the observation that mast cells constitutively release the HtrA1 protein, prompted us to investigate a possible involvement of the HtrA proteins in pediatric CM. Levels of the serum autoantibodies (IgG) against the recombinant HtrA proteins (HtrA1-4) in children with CM (n=36) and in healthy controls (n=62) were assayed. Anti-HtrA IgGs were detected using enzyme linked immunosorbent assay (ELISA) and Western-blotting. In the CM sera, levels of the anti-HtrA1 and anti-HtrA3 autoantibodies were significantly increased when compared to the control group, while the HtrA protein levels were comparable. No significant differences in the anti-HtrA2 IgG level were found; for the anti-HtrA4 IgGs lower levels in CM group were revealed. In healthy children, the IgG levels against the HtrA1, -3 and -4 increased significantly with the age of children; no significant changes were observed for the anti-HtrA2 IgG. Our results suggest involvement of the HtrA1 and HtrA3 proteins in pediatric CM; involvement of the HtrA4 protein is possible but needs to be investigated further. In healthy children, the autoantibody levels against HtrA1, -3 and -4, but not against HtrA2, increase with age