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Background: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare hypersensitivity reaction involving the skin and various visceral organs; the kidneys are the second most affected organ. Many drugs are reported to be associated with DRESS, particularly antiepileptic agents and allopurinol. Certain human leukocyte antigen (HLA) haplotypes, in combination with a particular drug, can further contribute to an increased risk of DRESS. Symptoms often develop 2 to 8 weeks after drug initiation. If diagnosis is delayed, DRESS can be a life-threatening condition. Case Reports: We present cases of 2 patients. The first patient was an 86-year-old Polish woman who developed acute kidney injury and skin lesions with accompanying leucocytosis and eosinophilia during long-term antibiotic therapy with piperacillin/tazobactam and ciprofloxacin. The second patient was a 37-year-old Asian woman with predialysis chronic renal disease stage V in the course of IgA nephropathy. Two weeks after starting allopurinol in a standard dose, she presented with maculopapular rash, facial edema, fever, liver injury, and eosinophilia. Renal function started to deteriorate, but she did not require dialysis. In both cases, the discontinuation of the above-mentioned drugs and the introduction of steroid therapy and intravenous immunoglobulins allowed for clinical improvement and recovery. In the second case, the extended 4-locus HLA typing was performed retrospectively, and allele HLA-B*5801 was found. Conclusions: Due to the rare occurrence and heterogeneous manifestation of DRESS, its diagnosis can pose many difficulties. In-depth analysis of symptoms, medicines taken, and laboratory findings enable the implementation of appropriate treatment and recovery. [ABSTRACT FROM AUTHOR]

We would like to demonstrate the difficulty of treatment in a patient after kidney transplantation (KTX) who developed chronic urinary tract infection (UTI) with a multi‐drug resistant ESBL‐producing Klebsiella pneumoniae. The patient underwent several treatment interventions including supportive therapy with bacteriophages. This article presents a case of a 60‐year‐old patient after KTX repeatedly admitted to the hospital with recurrent UTIs caused by ESBL‐producing Klebsiella pneumoniae showing variable susceptibility to carbapenems and full susceptibility to colistin only. KTX was performed due to renal insufficiency caused by polycystic kidney disease. The patient experienced 12 severe episodes of UTI due to K pneumoniae within 15 months since transplantation. In an attempt to curb the ongoing infections, phage therapy (PT) was applied on the experimental basis, coordinated by the Phage Therapy Unit of the Hirszfeld Institute in Wroclaw, Poland. Eventually, the patient fully recovered following nephrectomy of his own left kidney where cysts were the suspected reservoir of bacteria. The patient completed 29 days of PT. PT caused no reported side effects in the described case of the KTX recipient, although its role in controlling chronic UTI caused by K pneumoniae is unclear. More studies are needed in the population of kidney transplant recipients. [ABSTRACT FROM AUTHOR]

Hand hygiene (HH) is often under-discussed in clinical work, but it is hard to overestimate its role in preventing health care associated infections (HCAIs), especially among immunocompromised populations such as transplant patients. This study aimed to investigate the compliance of doctors in transplant departments in Poland with HH and other selected infection control measures. An on-line cross-sectional survey was carried out among doctors from all Polish transplant departments listed by POLTRANSPLANT. The questionnaire addressed HH in different clinical settings and based on the World Health Organization (WHO) "My 5 Moments for Hand Hygiene." Completed questionnaires were obtained from 204 physicians (49% women; response rate: 24.7%). The lowest proportion of doctors who always comply with HH was observed in 2 out of 5 critical moments for hand hygiene: "before touching a patient" (40.2%) and "after contact with patient surroundings" (21.6%). Most respondents declared correct HH action that they would apply in a particular clinical situation as listed in the survey. More than half of doctors (57.4%) declared disinfecting stethoscopes "before and/or after each use." The lack of alcohol-based hand-rub nearby or nonfunctional containers, daily rush, and occurring emergencies were identified as the main reasons for noncompliance with HH recommendations. Doctors in transplant departments in Poland have a satisfactory level of knowledge about HH in various situations. However, further organizational and educational activities are needed to promote compliance with HH recommendations in health care facilities. • Doctors in transplant departments in Poland have satisfactory knowledge about hand hygiene (HH). • Female doctors declare better HH compliance. • Physicians declare better HH compliance than surgeons. • No alcohol-based hand rub nearby was named the main reason for not performing HH. • Declared stethoscope disinfection rates among studied doctors were very high. [ABSTRACT FROM AUTHOR]

• Transplant recipients of solid organs report better sleep after transplantation. • Females reported a more positive overall impact of transplantation on sleep; however, they experienced worse sleeping hygiene, when asked specifically. • Women get out of bed later than men (30 minutes difference), need more time to fall asleep, and more often experience sleepiness the next day. Males in our study have better well-being the next day. • Older transplant recipients reported more frequent awakenings at night and instances of waking up before the scheduled time. Sleep plays a crucial role in maintaining health. Transplant patients are exposed to numerous stressors and are at risk of sleep disturbances. The aim of this study was to assess the sleep patterns of transplant patients. An anonymous paper survey was carried out among patients from one transplant center in Poland. Respondents were asked about the quality and quantity of sleep and the overall impact of the transplantation on their night rest. Data were collected from June to November 2023. Data were obtained from 212 respondents (122 males and 90 females), aged 48.38 ± 13.68. The positive impact of transplantation on sleep hygiene was indicated by 57.4% of respondents, 28.9% observed no impact, and 13.6% rated the impact as negative. Our study showed that sleep is more satisfying in males than in females (62.8% of males and 46.7% of females). The analysis revealed that 38.9% of females need 30 minutes more than men to fall asleep. Additionally, females tend to get up half an hour later compared to men. About 71.9% of males declared good well-being the next day compared to 62.2% of females. Furthermore females declared more sleepiness the next day. The study also showed that older transplant recipients (over 50 years-of-age) report more frequent awakenings at night. The data collected showed differences in sleep patterns according to gender and age. Females and older patients should be screened for sleep disturbances during post-transplantation care. [ABSTRACT FROM AUTHOR]

Male sex is a risk factor for colorectal cancer (CRC) with higher illness burden and earlier onset. Thus, we hypothesized that loss of chromosome Y (LOY) in the tumor micro-environment (TME) might be involved in oncogenesis. Previous studies show that LOY in circulating leukocytes of aging men was associated with shorter survival and non-hematological cancer, as well as higher LOY in CD4 + T-lymphocytes in men with prostate cancer vs. controls. However, nothing is known about LOY in leukocytes infiltrating TME and we address this aspect here. We studied frequency and functional effects of LOY in blood, TME and non-tumorous tissue. Regulatory T-lymphocytes (Tregs) in TME had the highest frequency of LOY (22%) in comparison to CD4 + T-lymphocytes and cytotoxic CD8 + T-lymphocytes. LOY score using scRNA-seq was also linked to higher expression of PDCD1, TIGIT and IKZF2 in Tregs. PDCD1 and TIGIT encode immune checkpoint receptors involved in the regulation of Tregs function. Our study sets the direction for further functional research regarding a probable role of LOY in intensifying features related to the suppressive phenotype of Tregs in TME and consequently a possible influence on immunotherapy response in CRC patients. [ABSTRACT FROM AUTHOR]

Objectives: Health care services in Poland are delivered by public and private providers. The aims of this study were to assess the attitudes towards private and public health care services in Poland and to identify differences between them, in the opinion of physicians.Material and Methods: A questionnaire-based survey was carried out among physicians attending mandatory courses delivered at the School of Public Health, the Centre of Postgraduate Medical Education in Warsaw, Poland. The questionnaire included 29 questions concerning private and public health care services.Results: Completed questionnaires were obtained from 502 physicians (67.7% females), aged 42.1±10.8 years, with a response rate of 77.2%. In the opinion of the surveyed doctors, the major advantages of private health care units, in comparison with public ones, are short waiting times for an appointment (88.2%), an efficient on-site service (78.6%) and convenient appointment times (75.7%). The respondents gave high scores to items such as relations with patients (p < 0.001), superiors (p < 0.001) and colleagues (p = 0.03) when working in private, rather than public, institutions. In the opinion of physicians, public health care institutions guarantee better employment conditions (44.4% vs. 13%; p < 0.001) and security (29.1% vs. 11.1%; p < 0.001) than private ones. The respondents did not observe any differences (p > 0.05) between public and private facilities in terms of the involvement of medical staff and infrastructure. There were significant differences (p < 0.001) in the perception of working conditions in public and private health care institutions depending on the medical education level and the place of primary employment.Conclusions: Among physicians in Poland, private medical institutions are perceived as better organized and granting faster as well as more comprehensive access to health care services when compared to public ones. Closing the gaps between working conditions in public and private units could encourage physicians to practice in the public health care sector. Int J Occup Med Environ Health. 2020;33(2):195-214. [ABSTRACT FROM AUTHOR]

Objective: To compare the effect of RYGB and OAGB on patients after failed treatment of obesity by laparoscopic sleeve gastrectomy (LSG).Study Design: A case-control study based on a prospectively maintained database of reoperated patients after failed LSG, which included 33 patients who underwent RYGB conversion and 47 patients who underwent OAGB conversion.Result: The mean %EBWL after a 5-year follow-up for RYGBc vs OAGBc was 84.04% vs 72.95% (p = 0.2176), respectively. Complete long-term diabetes remission was observed significantly more frequently in the OAGBc than in the RYGBc group (97.3% vs 33%; p = 0.035). There were no other statistically significant differences in the remission rate of comorbidities between RYGBc and OAGBc: hypertension 30% vs 27.3% (p = 0.261), dyslipidemia 83.3% vs 59.1% (p = 0.277), OSAS 100% vs 60% (p = 0.639), and GERD 40% vs 71.4% (p > 0.99), respectively. 7 patients were newly diagnosed with GERD after OAGBc and none after RYGBc. There were no statistically significant differences in the number of complications between the OAGBc and RYGB groups. The Comprehensive Complication Index was 17.85 (± IQR 29.6) in the OAGBc group and 14.92 (± IQR 21.75) in the RYGBc group (p = 0.375).Conclusion: The authors recognized complete long-term type 2 diabetes remission after conversion surgery as the most relevant difference, where the OAGB variety was found superior for its better efficacy. Any other statistically significant differences in the consequences after both conversion procedures used after the failure of LSG have not been stated. Both methods therefore can be considered to complete the initial treatment, considering the preferences and individual burdens of the patients. [ABSTRACT FROM AUTHOR]

Background: Accumulating evidence indicates alterations in lipid metabolism and lipid composition in neoplastic tissue. Earlier nuclear magnetic resonance studies showed that the contents of major lipid groups, such as triacylglycerols, phospholipids and cholesterol, are changed in colon cancer tissue. Methods: In this study, a more detailed analysis of lipids in cancer and tumor adjacent tissues from colorectal cancer patients, using liquid chromatography–mass spectrometry, allowed for comparison of 199 different lipids between cancer tissue and tumor adjacent tissue using principal component analysis. Results: Significant differences were found in 67 lipid compounds between the two types of tissue; many of these lipid compounds are bioactive lipids such as ceramides, lysophospholipids or sterols and can influence the development of cancer. Additionally, increased levels of phospholipids and sphingolipids were present, which are major components of the cell membrane, and increases in these lipids can lead to changes in cell membrane properties. Conclusions: This study showed that many complex lipids are significantly increased or decreased in colon cancer tissue, reflecting significant alterations in lipid metabolism. This knowledge can be used for the selection of potential molecular targets of novel anticancer strategies based on the modulation of lipid metabolism and the composition of the cell membrane in colorectal cancer cells. [ABSTRACT FROM AUTHOR]

The primary aim of this study is to compare the clinical course and laboratory parameters of acute cholecystitis in patients with diabetes vs. patients without diabetes. The study involved patients who underwent emergency cholecystectomy in the Department of General, Endocrine and Transplant Surgery of University Clinical Center in Gdansk (Poland) between 2007 and 2017. There were 267 patients included in the study. The control group of 197 patients was age and sex matched at a 3:1 ratio. The following was compared between the groups: symptoms at admission, course of surgery, postoperative course, length of hospitalization, total costs of hospitalization and antibiotic therapy, other than routine perioperative prophylaxis. There was no significant difference between the patients with and without diabetes regarding symptoms at admission. Operative and postoperative complication rates were significantly higher in the patients with diabetes. The operative time and length of hospitalization were significantly longer in the study group. The conversion rate was not higher in the study group, but classic surgery was performed significantly more often. The patients without diabetes had less pronounced symptoms with more locally advanced disease. Our study demonstrates that patients with diabetes have a significantly more eventful course of acute cholecystitis than patients without diabetes. Patients with diabetes should therefore be qualified for cholecystectomy early in the course of acute cholecystitis. [ABSTRACT FROM AUTHOR]

Corynebacterium coyleae is part of the commensal microflora of the skin, urethra, mucous membranes, and genital tract. Isolates from patients with urinary tract infection (UTI) were reported, but the pathogenic potential of this species has not been defined yet. The aim of the study is to determine whether C. coyleae could be the etiological agent of UTI and to analyze its antibiotic susceptibility. Urine samples were cultured quantitatively according to accepted laboratory procedures. The identification of bacterial isolates was carried out using the Vitek MS (bioMérieux) and antibiotic susceptibility was tested using disc diffusion according to EUCAST guidelines. Between 1 January 2017 and 30 October 2018, a total of 39 C. coyleae strains were isolated. This represented 0.32% of all urine samples cultured in the laboratory during the collection period. The strains were isolated from samples obtained from 35 women and 3 men (age median for all—64 years). One female patient presented with C. coyleae in her urine twice at an interval of 21 months. In six cases of UTI, C. coyleae was isolated in monoculture. The isolates had the same resistance pattern. A total of 11 strains were obtained from cases with a clinical diagnosis of UTI. In 13 cases, the strain was cultured in a monoculture and in 28 cases with accompanying species. All strains were susceptible to vancomycin. However, resistance to ciprofloxacin was observed for 58.4% of the strains. Urine isolates of C. coyleae must be considered as contamination or normal flora in most cases (28/39, 72%). In the remaining cases, it can be considered as potential etiologic agents, mostly in women and especially in the 6 UTI cases where C. coyleae was found as the single culture-positive species. Several of these isolates demonstrate resistance to antibiotics commonly used in empiric treatment of urinary tract infections. [ABSTRACT FROM AUTHOR]

• Liquid biopsy is an arising tool in oncology including assessment of prognosis in CRC • Presence of ctDNA with KRAS mutation is associated with inferior prognosis • High concentration of ctDNA with KRAS mutation is associated with inferior prognosis • Subgroup of KRAS tumor and plasma positive patients is likely to have worse prognosis • Establishing cut-off concentrations is warranted for further clinical implementation Liquid biopsy is a novel tool in oncology. It provides minimally invasive detection of tumor specific DNA. This review summarizes data on presence of circulating tumor DNA in serum or plasma of CRC patients as a potential negative prognostic factor. The systematic review was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). The search was performed using PubMed, Web of Science and Scopus. In total 18 articles with a total of 1779 patients met the inclusion criteria. Six out of 8 studies found that presence of ctDNA in plasma/serum was associated with inferior overall survival. All 6 studies found that high concentrations of ctDNA in plasma/serum was associated with inferior overall survival. Presence or high concentrations of KRAS mutation in plasma or serum were associated with inferior prognosis. Establishing cut-off concentrations is warranted for further clinical implementation of liquid biopsy. [ABSTRACT FROM AUTHOR]