Rola nietolerancji pokarmowych w powstawaniu objawów zespołu jelita nadwrażliwego u dorosłych

Wielu pacjentów z zespołem jelita nadwrażliwego (IBS) wiąże występowanie swoich dolegliwości ze strony przewodu pokarmowego ze spożywaniem pokarmów. Nietolerancje pokarmowe słabo wchłanialnych wodorowęglanów powodują objawy zbliżone do tych, jakie zgłaszają pacjenci z IBS. W ostatnich latach zaczęło pojawiać się coraz więcej doniesień na temat udziału nietolerancji pokarmowych w powstawaniu objawów IBS. Ukazały się również raporty wykazujące korzystne efekty stosowania restrykcyjnej diety z ograniczeniem zdolnych do fermentacji, słabo wchłanialnych wodorowęglanów u niektórych pacjentów z IBS, konieczne jest jednakże potwierdzenie tych rezultatów w dalszych kontrolowanych badaniach. W pracy na podstawie systematycznego przeglądu piśmiennictwa dokonano omówienia związku występujących w IBS objawów z nietolerancją zdolnych do fermentacji, słabo wchłanialnych węglowodanów, takich jak: laktoza, fruktoza, fruktany, sorbitol i inne alkohole cukrowe (poliole), określanych mianem fermentujących oligo-, di-, monosacharydów i polioli (FODMAPs). Forum Medycyny Rodzinnej 2011, tom 5, nr 3, 239–24

Analysis of the role of education and sport in the heavy burden of obesity

Obesity has become the global pandemic of the world. The epidemiological rise has only happened in recent decades. Unfortunately, the disease affects people of all ages. The most prominent characteristics of the disorder are excessive fat accumulation, body mass index exceeding the number of 30, and general lowering of the quality of life. The consequences are observed in the whole organism. The disruptions affect one’s overall homeostasis. Certain diseases are specifically associated with excessive fat mass. When not properly managed, obesity leads to chronic illnesses and severe comorbidities, the most morbid one being death. Thus, effective therapeutic approaches are needed. Focus on education and physical activity are the best way to tackle this problem. The aim of this study is to check the factors and changes necessary to lose weight in obese patients in Poland. The main question regarded the role of sport and proper education in maintaining or losing weight in the Polish society. In order to analyse the issue, an Internet survey was prepared and disseminated in March and April 2023. Over half of the respondents have ever used a diet. Over 8 out of ten of them achieved the success in the set task. When asked about physical activity, the most respondents chose option 30-60 minutes per day. The preferred type of physical activity was most commonly walking. When asked if sport enabled the respondents to lose or maintain weight – 63,5% confirmed. 72% of respondents experienced education regarding healthy lifestyle, most commonly at home. Over 60% of respondents believed they were well informed about recommended behaviours. Over 50% of them confirmed their education is sufficient to lose weight. Maintaining healthy regimes is key to a healthy life. However, not all people are properly educated how to do that. In fact, there is a tendency of overestimation of one’s education in those topics. All in all, proper experience and routines are necessary

Zastosowanie testu Syphilis Total Ab na aparacie Evolis (firmy BIO-RAD) do prowadzenia badań przeglądowych w krwiodawstwie

Background: Syphilis Total Ab BIO-RAD (France) is designed for detection of antibodies to Treponemapallidum antigens in human serum and plasma. Tests are performed in automatic analyzers Evolis (BIORAD).The aim was to evaluate the advantages of the Syphilis Total Ab BIO-RADtest for blood donor screening in Poland. Specificity, sensitivity, repeatability and reproducibility of S/Co values were evaluated. After 18 months of using the test at the Military Blood Center (WCKiK), the results were analyzed and compared to those obtained with other EIA tests which had been in use for 36 months before the implementation of Syphilis Total Ab BIO-RAD.Material and methods: Specificity evaluation was performed at the Institute Hematology and Transfusion Medicine (IHiT) on samples collected from 2058 currently screened donors. Assessment of clinical sensitivity was based on study outcome of: 1) seropositive sample panels (confirmed), raw and prepared by dilution of positive archive serum, 2) seroconversion panel (SeraCare), 3) samples reactive in a prospective study performed for assessment of test specificity. Additionally, we analyzed results for 48 940 donations tested with Syphilis Total AbBIO-RAD between January 2015 and June 2016 and the results were compared with results for 89.672 donations tested in the period 2012–2014 with Trepanostika TP rec. bioMerieux (France).Results: Specificity of Syphilis Total Ab BIO-RAD test is equal to 99.9%; repeat reactive (RR) samples with indeterminate confirmation results were considered false reactive. In our own panel studies all samples were found reactive both in the evaluated assay and in reference test (100% compliance). The same number of reactive results was reported for both tests in seroconversion panel studies. Frequency of confirmed RR results in the period 2012–2016 at WCKiK was calculated at 0.0079% (11/138,612 donations). Specificity of Syphilis Ab BIO-RAD was equal to 99.98% as compared to 99.79% reported for the period before test implementation and the positive predictive value of the evaluated test was significantly higher (40% vs. 2.65%, p < 0.05).Conclusions: The S/Co values for specificity, sensitivity, reproducibility and repeatability of Syphilis Total Ab Test BIO-RAD performed on the analyzer Evolis were found satisfactory. The study outcome demonstrates that the choice of a higher-specificity test (positive predictive values) brings about measurable cost-cutting (smaller number of repeat, verification and control tests performed as well as reduced blood component wastage) and reduction in number of temporarily disqualified donors.Wstęp: Test Syphilis Total Ab firmy BIO-RAD (Francja) jest przeznaczony do wykrywania przeciwciał skierowanych do antygenów Treponema pallidum w ludzkiej surowicy lub osoczu. Oznaczenia są prowadzone w automatycznych analizatorach Evolis firmy BIO-RAD.Celem badań była ocena przydatności testu Syphilis Total Ab BIO-RAD do prowadzenia badań przeglądowych krwiodawców w Polsce. Analizowano swoistość, czułość testu oraz powtarzalność i odtwarzalność wartości S/Co. Przeanalizowano także wyniki badań z 18 miesięcy po wdrożeniu testu w Wojskowym Centrum Krwiodawstwa i Krwiolecznictwa (WCKiK), a następnie porównano z wynikami badania innym testem EIA uzyskanymi w okresie 36 miesięcy poprzedzających zmianę testu.Materiał i metody: Swoistość testu oszacowano w Instytucie Hematologii i Transfuzjologii (IHiT) na podstawie badania 2058 próbek pochodzących z bieżących badań krwiodawców. Czułość kliniczną oceniono na podstawie wyników badania: 1) paneli próbek serododatnich (potwierdzonych) nierozcieńczonych i przygotowanych przez rozcieńczenie dodatniej surowicy archiwalnej, 2) panelu serokonwersyjnego (SeraCare), 3) próbek reaktywnych w badaniu prospektywnym wykonanym w celu oceny specyficzności testu. Dodatkowo przeanalizowano wyniki badania 48 940 donacji za pomocą testu Syphilis Total Ab firmy BIO-RAD po wprowadzeniu do rutynowych badań przeglądowych (od stycznia 2015 r. do czerwca 2016 r.) i porównano z wynikami badań przeglądowych w okresie wcześniejszym (89 672 donacji w latach 2012–2014 badano testem TrepanostikaTP rec. firmy bioMerieux, Francja).Wyniki: W badaniu ewaluacyjnym swoistość testu Syphilis Total Ab BIO-RAD wynosiła 99,9% (uznając RR z nieokreślonym wynikiem testu potwierdzenia za wynik fałszywie reaktywny). W badaniach paneli własnych wszystkie próbki były zgodnie reaktywne w teście ocenianym i w teście odniesienia (zgodność 100%). W badaniach panelu serokonwersyjnego w obu testach uzyskano taką samą liczbę wyników reaktywnych. Częstość potwierdzonych wyników powtarzalnie reaktywnych uzyskanych w okresie 2012–2016 wynosiła 0,0079% (11/138 612 donacji), przy czym swoistość testu Syphilis Ab BIO-RAD wynosiła 99,98% w porównaniu z 99,79% w okresie poprzedzającym zmianę testu, a pozytywna wartość predykcyjna testu ocenianego była istotnie statystycznie wyższa (40% vs. 2,65%, p < 0,05).Wnioski: Test Syphilis Total Ab firmy BIO-RAD wykonywany na analizatorze Evolis charakteryzuje się dobrą swoistością, czułością oraz odtwarzalnością i powtarzalnością wartości S/Co.Uzyskane wyniki pokazują, że poprawa swoistości (pozytywnej wartości predykcyjnej) badania przeglądowego przez dobór testu pod kątem tego parametru przynosi wymierne ograniczenie kosztów (m.in. przez zmniejszenie liczby badań powtarzanych i weryfikacyjnych, kontrolnych oraz zniszczeń składników krwi) oraz prowadzi do ograniczenia liczby dyskwalifikowanych czasowo dawców

Dlaczego pacjenci z zespołem jelita nadwrażliwego są „trudni”? Praktyczne aspekty rozważań psychologicznych

Z uwagi na duże rozpowszechnienie zaburzeń czynnościowych większość lekarzy POZ i gastroenterologów ma pod opieką pacjentów z zespołem jelita nadwrażliwego. Efekty dotychczas stosowanych terapii nie są w pełni zadowalające. Wpływ czynników psychologicznych na przebieg kliniczny zespołu jest bardzo znaczny. Poznanie i zrozumienie profilu emocjonalnego tej grupy chorych oraz nawiązanie dobrych relacji pomiędzy pacjentem i lekarzem jest bardzo dobrym, pozbawionym działań ubocznych, środkiem leczniczym. Forum Medycyny Rodzinnej 2011, tom 5, nr 3, 247–25

Doctor–Patient Communication – According to Patients

This article is concerned with the important issue of communication between doctors and patients. A patient’s agreement to proposed therapy, his or her cooperation, and engagement in the therapeutic process to a large extent depend on the communicative skills of a doctor or therapist. This article stems from the survey carried out among the patients of the Clinical Hospital of the University Medical Centre in Gdansk, and, thereby, it attempts to evaluate the aforementioned skills

Talent management practices - empirical evidence from Polish healthcare entities

Background: In the Polish healthcare system, there is a high demand for highly qualified medical staff who can be considered talents. Therefore, the use of appropriate talent management practices by managers of healthcare entities is becoming increasingly important. Purpose: This study examines the respondents' perception of the current use of selected talent management practices in healthcare entities in Poland. It was also important to investigate the relationship between talent management practices and employee retention and check whether the assessments of individual talent management practices differ depending on the type of healthcare entity and the education of managers. Because the spectrum of talent management processes is wide, in this article, we pay attention to talent acquisition and identification, competence development and employee appraisal. Design/methodology/approach: A questionnaire for managers of Polish healthcare entities was used to collect the data. 120 respondents took part in the research. A five-point Likert scale was adopted to assess individual talent management practices. In order to examine the properties of the measurement scale and the items that make it up, a reliability analysis was performed. Data were then analyzed using descriptive statistics, Spearman's rho correlation analysis, Kruskal-Wallis, and Mann-Whitney U tests. Findings: The study showed that the talent management level in Poland's public healthcare entities is not sufficiently advanced. The study's results also revealed the positive impact of talent management practices on employee retention. The analysis shows that the type of medical entity differentiates the level of development of employees' professional competencies and evaluation. No differences in talent management level were observed depending on the managers' education. Originality/value: In practice, this study highlights problematic areas of talent management practices in healthcare entities. The study contributes to the new knowledge on the perception of managers of healthcare entities regarding the use of talent management practices in the Polish health sector

Human intramuscular hyperimmune gamma globulin (hIHGG) Anti-SARS-CoV-2 : characteristics of intermediates and final product

This study aims to characterize the intermediates, and the final product (FP) obtained during the production of human intramuscular hyperimmune gamma globulin anti-SARS-CoV-2 (hIHGG anti-SARS-CoV-2) and to determine its stability. Material and methods: hIHGG anti-SARS-CoV-2 was fractionated from 270 convalescent plasma donations with the Cohn method. Prior to fractionation, the plasma was inactivated (Theraflex MB Plasma). Samples were defined using enzyme immunoassays (EIA) for anti-S1, anti-RBD S1, and anti-N antibodies, and neutralization assays with SARS-CoV-2 (VN) and pseudoviruses (PVN, decorated with SARS-CoV-2 S protein). Results were expressed as a titer (EIA) or 50% of the neutralization titer (IC50) estimated in a four-parameter nonlinear regression model. Results: Concentration of anti-S1 antibodies in plasma was similar before and after inactivation. Following fractionation, the anti-S1, anti-RBD, and anti-N (total tests) titers in FP were concentrated approximately 15-fold from 1:4 to 1:63 (1800 BAU/mL), 7-fold from 1:111 to 1:802 and from 1:13 to 1:88, respectively. During production, the IgA (anti-S1) antibody titer was reduced to an undetectable level and the IgM (anti-RBD) titer from 1:115 to 1:24. The neutralizing antibodies (nAb) titer increased in both VN (from 1:40 to 1:160) and PVN (IC50 from 63 to 313). The concentration of specific IgG in the FP did not change significantly for 14 months. Conclusions: The hIHGG anti-SARS-CoV-2 was stable, with concentration up to approximately 15-fold nAb compared to the source plasma pool

Interleukin-6 as a Predictive Factor of Pathological Response to FLOT Regimen Systemic Treatment in Locally Advanced Gastroesophageal Junction or Gastric Cancer Patients

Background: Perioperative treatment is a gold standard in locally advanced gastric cancer or GEJ cancer in the Western population. Unfortunately, the response rate after neoadjuvant chemotherapy (NAC) remains limited. Moreover, there are currently no biomarkers enabling an individual prediction of therapeutic efficacy. The aim of this study was the identification of serum biomarkers of early response to NAC. Methods: We conducted this prospective study in the MSCNRIO in Warsaw, Poland. A total of 71 patients and 15 healthy volunteers gave informed consent. Complete blood count, carcinoembryonic antigen (CEA), carcinoma antigen 125 (CA125), carcinoma antigen 19.9 (CA19.9), and fibrinogen (F) were measured at baseline and before every cycle. Circulating tumour cells (CTCs) and interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin-8 (IL-8), and interleukin-10 (IL-10) were measured in a pilot group of 40 patients at baseline and before cycle two (C2) and cycle three (C3). Results: Of all the measured parameters, only the IL-6 serum level was statistically significant. The IL-6 level before C2 of chemotherapy was significantly decreased in the complete pathological response (pCR) vs. the non-pCR group (3.71 pg/mL vs. 7.63 pg/mL, p = 0.004). In all patients with an IL-6 level below 5.0 pg/mL in C2, tumour regression TRG1a/1b according to the Becker classification and ypN0 were detected in postoperative histopathological specimens. The IL-6 level before C1 of chemotherapy was significantly elevated in ypN+ vs. ypN0 (7.69 pg/mL vs. 2.89 pg/mL, p = 0.022). Conclusions: The trial showed that an elevated level of IL-6 prior to treatment and C2 might be a predictor of pathological response to NAC

Boron Cluster Modification with Antiviral, Anticancer, and Modulation of Purinergic Receptors' Activities Based on the Nucleoside Structure

Nucleoside analogs have been in clinical use for several decades and have become cornerstones of treatment for patients with cancer or viral infections [1,2]. This is complemented with nucleoside antibiotics, a large family of microbial natural products and synthetic derivatives derived from nucleosides and nucleotides [3]. The approval of several new nucleoside drugs over the past decade demonstrates that this class of compounds still possesses strong potential [1,2]. The potential of nucleosides in chemotherapy is enhanced by development of new chemistries for nucleoside modification, better understanding of molecular mechanisms of nucleoside drugs’ actions [4], and pro‐drug technology [5,6]. One of the new developments in the medicinal chemistry of nucleosides is nucleoside derivatives comprising a boron component [7]. The boron part can contain a single boron atom [8] or several boron atoms in the form of a boron cluster (Figure 1.2.1) [9–11]

Current status and achievements of Polish transfusion medicine

Transfusion of blood and blood components is one of the widely used medical procedures. The responsibility for provision of blood and blood components lies with Polish blood transfusion centers (CKiK) substantively supervised by the Institute of Hematology and Transfusion Medicine. Hospital based blood banks, hospital wards, immunohematology laboratories are supervised by CKiK. Every year approximately 600 thousand people donate blood, more than 75% of which are regular donors. The annual number of donations is maintained at a constant level of about 1.3 million. The aim of this position paper is to present the current status, achievements and advancement in collection, preparation and testing procedures and methods used to obtain the best possible quality blood components dedicated for clinical use. The aim is also to show the structure of blood transfusion service in Poland. Collaboration of all organizational units involved in transfusion medicine is crucial for providing high quality health care for patients. Polish transfusiologists and blood transfusion officers have largely contributed to transfusion science with numerous publications and significant research work. The implementation of novel methods and ongoing research positions Polish blood transfusion service among those of highly developed countries