Search

Anna Bednarek,1 Iwona Bodys-Cupak,2 Adrianna Serwin,1 Elżbieta Cipora3 1Department of Health Promotion, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland; 2Department of Nursing Fundamentals, Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland; 3Medical Institute, Jan Grodek State University in Sanok, Sanok, PolandCorrespondence: Anna Bednarek, Department of Health Promotion Chair of Nursing Development, Faculty of Health Sciences, Medical University of Lublin, S. Staszica 4-6 Street, 20-081, Lublin, Poland, Tel +48 81 448 67 20 ; +48 607 607 115, Email anna.bednarek@umlub.plIntroduction and Objective: An important role in building opinions and attitudes regarding breastfeeding by mothers is played by the medical staff taking care of the mother woman expecting a baby. Breastfeeding is a standard in infant nutrition. The knowledge and support of the medical staff can help a woman make the decision to breastfeed. At the same time, it creates conditions for an optimal working environment for medical staff, affecting the quality of care. The aim of the study was identify mothers’ attitudes towards breastfeeding in the context of health safety and professional lactation education.Materials and Methods: Data for the study were obtained on the basis of a proprietary questionnaire and a standardized research tool, which was the questionnaire for assessing knowledge and attitudes towards breastfeeding The Iowa Infant Feeding Attitude Scale designed by Arlene De la Mora (IIFAS). The study involved 439 women who gave birth to a child in the last 5 years.Results: Extensive knowledge about the benefits of breastfeeding for the child’s body is declared by 67.9% of women. The vast majority of respondents (94.1%) pointed to supporting the development of the immune system. Most women (85%) obtained information on breastfeeding from the Internet, and 58.5% from medical personnel. Most respondents (88.8%) assessed their partner’s attitude towards breastfeeding as positive. The result, The Iowa Infant Feeding Attitude Scale was equal to 50.97, which proves the positive attitude of women to breastfeeding.Conclusion: Promoting the best way to feed children, which is breastfeeding, plays an important role in building mothers’ opinions and attitudes about breastfeeding.Keywords: mothers’ attitudes towards breastfeeding, lactation education, health safety, nurses, midwives

Background: The World Health Organisation reports that melanoma had an incidence of 331,722 cases worldwide in 2022, ranking it 17th on the list of the most prevalent malignancies. This disease is a threat to public health as years of potential life lost from melanoma deaths constitute an economic and social burden; it is, however, curable if detected early. This study aims to show current trends in clinical trials for melanoma screening., Materials and Methods: The analysis was conducted using data from clinicaltrials.gov. The analysis considered both interventional and observational studies on melanoma screening. Only the studies with complete and active statutes by 4 September 2024 were included in the analysis., Results: Out of 25 studies registered in clinical trial databases regarding melanoma screening, 20% research advanced imagining techniques employing innovative machine learning algorithms, while 16% explore behavioural interventions., Conclusions: Intensification of behavioural interventions and health promotion activities is recommended.

In 2020 it is estimated that 281 million people were international migrants. Migrants constitute a potentially vulnerable population in terms of facing discrimination, poor living and housing conditions, and insufficient access to healthcare services. Due to the armed conflict in Ukraine in 2022, almost 10 million people crossed the Polish border within a year of the outbreak of the conflict. The objective of this paper is to present the use of primary healthcare services by people migrating from Ukraine to Poland and identify the barriers in access to healthcare by this group of persons. This study used a qualitative research technique in the form of an expert interview using individual in-depth interviews (IDI). The study group consisted of professionally active primary healthcare providers (doctors, nurses, and facility managers) in Poland. Research was carried out in the areas regarding the availability of healthcare, the potential threats and challenges, and possible system solutions. The results showed that the most common cause for doctor's appointments among migrants are respiratory infections, including COVID-19. Many cases were related to back pain, mainly resulting from the physical work of the patients. Additionally, some barriers to access and the provision of healthcare services for patients from Ukraine were identified. The majority (75%) of respondents indicated language as a significant barrier when providing services. Based on the study results, we recommend creating a dedicated website and telephone hotline for this group of persons as well as the use of traditional media to distribute information about access to healthcare services. It is also essential to focus on assistance for older people, since they may experience more difficulties with language and navigating the healthcare system.

Lung cancer is the leading cause of death among all the oncological diseases worldwide. This applies to both women and men; however, the incidence and mortality among women is on the rise. In 2020, lung cancer was responsible for 1.8 million deaths (18%). More than 90% of lung cancer cases and 77.1% of lung cancer deaths occur in countries with high and very high HDI (human development index) values. The aim of our study is to the present trends and most recent studies aimed at lung cancer screening. In the face of the persistently high mortality rate, conducting research aimed at extending already-implemented diagnostic algorithms and behavioural interventions focused on smoking cessation is recommended.

Alcohol addiction is characterized by extensive alcohol consumption that dominates other behaviours previously important to a patient. According to data from The State Agency for Prevention of Alcohol-Related Problems, up to 900,000 people in Poland are addicted to alcohol. On average, approximately 9.7 L of pure alcohol per capita was consumed in 2021. Alcohol addiction may cause severe health problems and is one the key risk factors for various diseases. Stress plays an important role in the process of alcohol addiction and is also a predictor for lower enjoyment in life. On the other hand, sense of coherence may be a stronger protective factor. The aim of our study was to verify the relation between the level of perceived stress among patients with alcohol addiction and satisfaction with life. Because sense of coherence is a disposition that allows for managing stress effectively, the latter should be reflected in the results of multivariate analyses that take both the level of stress and sense of coherence into account. In the present study, sense of coherence and perceived stress were negatively correlated; therefore, strengthening internal resources for managing difficult and stressful situations is recommended.

Introduction and Objective: The number of disabled persons is most often only estimated. The disabled require multidirectional, effective support in almost every field of functioning. There is no arbitrarily accepted definition of disability, and those currently available outline the ranges of support for which rehabilitation measures are necessary., Objective: The aim of the review is to present the problem areas that contribute to the definition of disability and their interdependence and effectiveness in relation to rehabilitation interventions, as well as identification of the most frequent medical and social problems interdependent on the quality and feasibility of rehabilitation interventions., Review Methods: Scientific literature in Polish and English for 1993-2023 and legal acts concerning the definition of disability, definition of rehabilitation and the problem of employment were reviewed. The following key words were used to search the NIZP-PZH, MZ, JAHEE and ISAP databases: disabled persons, definitions of disability, rehabilitation as a process, synchronization of thematic groups of disability definitions with the rehabilitation process., Brief Description of the State of Knowledge: Disability is a public health problem. The actual determination of the extent, medical and social needs of people with disabilities involves methods and measures for classifying people as disabled. The effects of treatment and rehabilitation are assessed by the level of functioning of the disabled in society., Summary: The multiplicity of characteristics included in the definitions of disability account for all problems in health and social terms. In view of the social, environmental and cultural changes, the scope of needs of people with disabilities is also changing, which can be seen in newly-developed definitions, including rehabilitation.

Pancreatic cancer (PC) is usually diagnosed at an advanced stage of its development, which results in lower overall survival (OS). Prognosis is also poor even with curative-intent surgery. Approximately 80% of patients with localized PDAC have micrometastases at the time of diagnosis, which leads to a worse prognosis than in other cancers. The objective of this study is to present the progress in the treatment of metastatic pancreatic cancer based on the recommendations of oncological scientific societies, such as ESMO, NCCN, ASCO, NICE and SEOM, over the last 5 years. Combined FOLFIRINOX therapy is mostly a recommended therapy among patients with good performance statuses, while gemcitabine is recommended for more fragile patients as a first-line treatment. The newest guidelines suggest that molecular profiling of the tumor should be the first step in determining the course of treatment. The use of modern molecular therapies in patients with specific gene mutations should extend the survival of patients with this disease.

Pancreatic ductal adenocarcinoma (PDAC) is an aggressive disease with high morbidity and mortality in which long-term survival rates remain disastrous. Surgical resection is the only potentially curable treatment for early pancreatic cancer; however, the right patient qualification is crucial for optimizing treatment outcomes. With the rapid development of radiographic and surgical techniques, resectability decisions are made by a multidisciplinary team. Upfront surgery (Up-S) can improve the survival of patients with potentially resectable disease with the support of adjuvant therapy (AT). However, early recurrences are quite common due to the often-undetectable micrometastases occurring before surgery. Adopted by international consensus in 2017, the standardization of the definitions of resectable PDAC (R-PDAC) and borderline resectable PDAC (BR-PDAC) disease was necessary to enable accurate interpretation of study results and define which patients could benefit from neoadjuvant therapy (NAT). NAT is expected to improve the resection rate with a negative margin to provide significant local control and eliminate micrometastases to prolong survival. Providing information about optimal sequential multimodal NAT seems to be key for future studies. This article presents a multidisciplinary concept for the therapeutic management of patients with R-PDAC and BR-PDAC based on current knowledge and our own experience.

Alcohol consumption is linked to over 200 diseases and injuries. It is also classified as a risk factor for several types of neoplasms as well as infectious diseases (i.e., HIV and tuberculosis). In 2019, among people aged 25 to 49, alcohol use was the leading risk factor for attributable burden of disease. There are many factors that affect alcohol drinking patterns such as social and economic status, social norms, cultural customs, availability of alcohol, etc. Stress also plays a significant role in the process of developing alcohol addiction. The aim of our study was to examine health patterns and stress levels among patients undergoing alcohol addiction treatment. The study sample consisted of 104 patients who were treated in a hospital ward due to alcohol dependence. Three standardized questionnaire tools were used to measure the sense of coherence and the level of stress among those patients. The main results suggest that the level of perceived stress correlated negatively with all dimensions of sense of coherence and all indicators of health behaviors, however, age was positively correlated with positive mental attitude, proper eating habits, and health behaviors. In conclusion, it is worth noting that developing patterns for positive health behaviors will make it possible to avoid alcohol dependence or reinforce the treatment results if alcohol dependence syndrome occurs.

Patients with pancreatic cancer who develop irreversible cancer cachexia have a life expectancy of less than 3 months. Therefore, it is extremely important to evaluate the patient's nutritional status as early as possible and to implement an appropriate nutritional intervention in order to reduce the risk of further weight loss and/or muscle loss, which affect the outcomes of cancer treatment and the correct nutritional treatment in patients with pancreatic cancer. A literature review was performed by using the PubMed and Cochrane quick search methodology. The main purpose of this review was to present the current approach to nutritional treatment in pancreatic cancer. The review included publications, most of which concerned clinical nutrition as part of the phase of treatment of patients with pancreatic cancer, nutritional and metabolic disorders in pancreatic cancer, and the period after pancreatic resection. Some of the publications concerned various nutritional interventions in patients with pancreatic cancer undergoing chemotherapy or surgical treatment (nutritional support before surgery, after surgery, or during palliative treatment). There is an unmet need for integrated nutritional therapy as a key part of the comprehensive care process for PC patients. Nutritional counseling is the first line of nutritional treatment for malnourished cancer patients, but pancreatic enzyme replacement therapy also constitutes the cornerstone of nutritional treatment for relieving symptoms of indigestion and maintaining or improving nutritional status.

(1) Background: Acceptance of illness is a process in which a person with an illness accepts its presence and treats it as an integral part of their life. With regard to alcoholism, acceptance of illness is one of the important elements of the healing process. (2) Methods: The study group consisted of 104 residents in an addiction treatment ward. Questionnaires SOC-29, AIS and PSS-10 were used to check levels of coherence, stress and acceptance of illness. The analysis was based on regression analysis. Patient age was analysed as a moderator of correlations between perceived indicators. Moderation analysis was based on the simple moderation model. (3) Results: The level of perceived stress correlated negatively with all areas of the sense of coherence and with acceptance of illness. All areas of the sense of coherence correlated with acceptance of illness positively. (4) Conclusions: The acceptance of illness by the patient is a factor that can be motivating for further treatment, through a positive approach to illness and strengthening the sense of control in experiencing it. The combination of strengthening behavioural, cognitive and motivational resources can be used in the treatment of people experiencing the challenges of addiction to alcohol.

Pancreatic cancer is the seventh most common cause of death in the group of oncological diseases. Due to the asymptomatic course, early diagnosis is difficult. Currently, early detection methods are only used in high-risk groups. A literature review based on the available results of observational studies on patients with pancreatic cancer and people from high-risk groups was used to summarize the knowledge on risk factors. The GLOBOCAN 2020 data were used to assess the epidemiological situation in Europe. A summary of screening recommendations was prepared based on the available documents from medical organizations and associations. Pancreatic cancer risk factors are divided into two main groups: non-modifiable factors, e.g., hereditary factors and age, which increase the risk of developing this disease, and modifiable factors-BMI, smoking, and alcohol consumption. Hereditary factors account for 10% of pancreatic cancer cases. The highly specialized methods of early detection, (MRI, CT, or EUS) are used for screening high-risk populations. Of all the imaging methods, EUS is considered the most sensitive for pancreatic cancer and allows an accurate assessment of the size of even small lesions (<30 mm) and the extent of tumour infiltration into blood vessels. The available studies vary on the level of sensitivity and specificity of these methods for the diagnosis of pancreatic cancer. EUS, MRI, and CT are also expensive procedures and in some patients can be invasive, which is one of the arguments against the introduction of population screening programs based on imaging methods. Therefore, it is important to look for viable solutions that would improve early detection. This is important from the point of view of healthcare systems in Europe, where almost 29% of all global pancreatic cancer cases are reported.

Introduction and Objective: The aim of the study was to examine the perception of medical services by oncological patients during the pandemic, identifying the key factors influencing it. The assessment of patient satisfaction with the treatment and care provided by doctors and other hospital staff provides important information on the quality of health services., Material and Methods: The study involved 394 patients diagnosed with cancer treated as inpatients in five oncology departments. The diagnostic survey method was used with a proprietary questionnaire and the standardized EORTC IN-PATSAT32 questionnaire. Calculations were carried out using Statistica 10.0 with p≤0.05 s considered statistically significant., Results: Overall patient satisfaction with cancer care was 80.77/100. Higher values were shown for the competences of nurses than for doctors, especially for their interpersonal skills (79.34 - nurses vs. 74.13 - doctors) and availability (80.11 - nurses vs. 75.6 - doctors). It was also shown that the level of satisfaction with cancer care increased with age; women rated cancer care lower than men (p = 0.031), particularly its aspect related to the competences of doctors. A lower degree of satisfaction was observed among rural residents (p=0.042). Other demographic data, such as marital status and education, determined satisfaction with cancer care on the selected scale although it did not affect the overall level of satisfaction., Conclusions: The analysed socio-demographic factors, primarily age, gender and place of residence, determined some of the scales concerning patient satisfaction with cancer care during the COVID-19 pandemic. The results of this and other studies of a similar profile should be used in the formation of health policy, particularly in implementing programmes to improve the quality of cancer care in Poland.

(1) Background: Pancreatic cancer is the cancer with the third-highest mortality rate, and forecasts indicate its growing share in morbidity. The basis of treatment is inpatient chemotherapy and there is a strong focus on palliative care. (2) Methods: A literature review was conducted based on the rapid review methodology in PubMed and Cochrane databases. The search was supplemented with publications from the snowball search. Qualitative assessment of included publications was performed using AMSTAR2 modified scheme. (3) Results: The review included 17 publications, of which majority concerned direct costs related to the adopted treatment regimen. Most of the publications focused on comparing the cost-effectiveness of drug therapies and the costs of palliative treatment. Other publications concerned indirect costs generated by pancreatic cancer. They particularly focused on the economic burden of lost productivity due to sickness absence. (4) Conclusion: The increase in the incidence of pancreatic cancer translates into an increase in the costs of the health care system and indirect costs. Due to the significant share of hospitalization in the health care structure, direct costs are increasing. The inpatient treatment regimen and side effects translate into a loss of productivity for patients with pancreatic cancer. Among gastrointestinal cancers, pancreatic cancer generates the second largest indirect costs, although it has a much lower incidence rate than the dominant colorectal cancer. This indicates a significant problem of the economic burden of this cancer.

Pancreatic cancer is the malignant disease with the highest mortality rate, and it ranks third in the world after lung and colon cancer. Identified factors that increase the risk of developing pancreatic cancer include chronic pancreatitis, radiation therapy to the pancreatic area due to another cancer, diabetes mellitus, obesity, smoking, and age. The objective of this study was to present the current state of knowledge on the quality of life of patients diagnosed with pancreatic cancer, factors that determine QoL, and ways of coping with the disease. The low curability and low survival rates of pancreatic cancer significantly affect the quality of life of patients, often in the form of significant deterioration, especially in terms of mental changes, cognitive functions, and coping with the disease. Cognitive decline with comorbid depression is also typical for patients with this type of cancer. Research has shown that the health-related quality of life of patients with pancreatic cancer is low, so further research is needed to improve the situation in this area.

Introduction and Objective: In each society there functions a group of the disabled who need assistance. The number and character of dysfunctional consequences determine the types of support, characteristics of health, medical and social problems, where a part of them are interdependent. The interdependence of these needs determine the consistency of rehabilitation actions, which result in the improvement of quality of life of disabled persons in their living environment, especially among rural inhabitants., Review Methods: The scientific medical, and sociological literature, as well as binding legal Acts from 1978-2021 were reviewed. Materials from Polish and English databases were analysed. Key words related to disability, its definition, models of disability, disability discrimination, inequalities in medical and social care, health and social needs, maps of needs, satisfaction with medical and social care, and quality of life were used., Brief Description of the State of Knowledge: Despite the fact that disability is a medical-social phenomenon, many reports concern only the treatment of the consequences of diseases, injuries, genetic/congenital or environmental defects. Disability is frequently identified with disease, which is inappropriate. Many researchers dealing with disability focus - quite rightly - on studies concerning social consequences, because they decide about the level of functioning of these persons in society and level of participation., Summary: Disability is not only a medical and social problem. Treatment does not end the essence of disability. Only interdisciplinary studies can change the life of these persons regarding great possibilities for their participation.

Introduction: Patient safety in long-term care is becoming an increasingly popular subject in the scientific literature. Organizational problems such as shortages of medical staff, insufficient numbers of facilities or underfunding increase the risk of adverse events, and aging populations in many countries suggests that these problems will become more and more serious with each passing year. The objective of the study is to identify interventions that can contribute to increasing patient safety in long-term care facilities., Method: A systematic review of secondary studies was conducted in accordance with the Cochrane Collaboration guidelines. Searches were conducted in Medline (via PubMed), Embase (via OVID) and Cochrane Library. The quality of the included studies was assessed using AMSTAR2., Results: Ultimately, 10 studies were included in the analysis. They concerned three main areas: promoting safety culture, reducing the level of occupational stress and burnout, and increasing the safety of medication use. Promising methods that have an impact on increasing patient safety include: preventing occupational burnout of medical staff, e.g., by using mindfulness-based interventions; preventing incidents resulting from improper administration of medications, e.g., by using structured methods of patient transfer; and the use of information technology that is more effective than the classic (paper) method or preventing nosocomial infections, e.g., through programs to improve the quality of care in institutions and the implementation of an effective infection control system., Conclusions: Taking into account the scientific evidence found and the guidelines of institutions dealing with patient safety, it is necessary for each long-term care facility to individually implement interventions aimed at continuous improvement of the quality of care and patient safety culture at the level of medical staff and management staff.

Background: According to the World Health Organization's statistics, 7 of the 10 main causes of death in 2019 were noncommunicable diseases. Health indicators are measures used to evaluate public health system effectiveness and functioning. Monitoring mortality rates from leading causes, life expectancy and other health indicators is essential to address their causes and adapt health systems to react adequately. The aim of this study is to present the dependencies of selected health care indicators and health outcomes., Methods: Based on the literature review conducted, selected health indicators, along with healthcare system data, were analyzed using Pearson's r correlation. The analyses included data from the Organization for Economic Cooperation and Development (OECD) presented in statistics and the Health at a Glance 2021 report and data collected as part of the preparation of the Financing Global Health 2020 report by the Institute for Health Metrics and Evaluation., Results: Health system resources are linked to health outcomes. The number of medical consultations, the number of nurses per patient or the level of financing of services under general health insurance are related to life expectancy and deaths due to causes that could have been avoided or treated., Conclusions: Life expectancy is positively correlated with access to general health insurance and public expenditure on healthcare. There is a need for all countries to provide their citizens with broad access to healthcare services.

The 2019 worldwide sales of Orphan Drugs were estimated at $136 billion USD, which constituted 16% of the global pharmaceutical prescription market and is expected to grow by 12% in the next 5 years. A better understanding of Orphan Drug pricing may contribute to on-going discussions on Orphan Drug Act (ODA) corrections in US or modifications of price setting mechanisms in EU. The objective of the study was comparison and analysis of the prices of Orphan Drugs in US and EU. All drugs with Orphan Drug status were compared in the US and EU. For the US prices, the US Department of Veterans Affairs (VA) was sourced. The EU List Prices came from six EU countries: Denmark, France, Germany, Greece, Poland, Spain. We found US prices to be higher than the six selected EU countries. The average Price Ratio was 1.64. The prices across EU countries were more homogeneous, while the number of the reimbursed and therefore available to patient medicines varied and was correlated with GDP per capita r = 0.87. Considered implementation of the External Reference Price system in US may generate significant savings in the US but may result in upward pressure on pricing of Orphan Drugs in EU. Centralization of the Orphan Drugs pricing negotiations in EU may prevent such development and offer a win-win opportunity for all involved parties.

The financial burden of adverse healthcare outcomes in Poland still remains unknown. The objective of the study was to estimate the cost of adverse healthcare outcomes in the Polish healthcare system. Cost calculation was performed on the basis of civil cases completed in Polish courts against doctors and healthcare entities. The research material consisted of 183 civil cases completed by a final judgment in 2011-2013. The case study was conducted in five out of forty-five district courts across the country. Out of 183 reviewed cases, 73 complaints ended up with favorable judgments (39.9%). The average value of the subject matter of the dispute was USD 78,675. The total expected value of lawsuits in the 183 reviewed cases was USD 11,299,020. The total amount awarded in 73 judgments from medical facilities to injured patients was USD 2,653,595, which on average means USD 36,351 per case. The average amount of awarded compensation was USD 33,317 per case. The average compensation amount in the analyzed cases was USD 11,724. The average one-time annuity for a patient was USD 11,788. The estimated costs of negative healthcare outcomes amounted to USD 8,000,000 per year.

Introduction: Alcohol dependence is one of the world's major health challenges. The salutogenic concept of health developed by Antonovsky focuses on the search for resources and factors supporting health. Its basic concept of the sense of coherence (SOC) focuses on strengthening the global orientation of the patient, and creating permanent internal resources that translate into the improvement of pro-health behavior, including the fight against alcoholism., Objective: The objective of this study was to determine the correlation between individual factors and the SOC as well as the influence of the SOC concept on pro-health behavior of people addicted to alcohol., Materials and Methods: The study group consisted of 110 men undergoing treatment in an addiction treatment ward. To check the level of the SOC, two standardized questionnaires, Antonovsky's "SOC-29 Life Orientation Questionnaire" and Juczyński's "Health Behaviour Inventory", were used. The correlation coefficient between the sociodemographic variables was checked using the Pearson's r test., Results: A positive correlation was found with the intensity of pro-health behaviors for three sociodemographic variables. In people aged 43-65 (r = 0.299; p = 0.030), people with primary/vocational education (r = 0.276; p = 0.015), and respondents living in rural areas (r = 0.303; p = 0.028) a greater SOC was associated with pro-health behaviors., Conclusions: Individuals addicted to alcohol are characterized by a low SOC and a low level of pro-health behaviors. Strengthening the internal level of the SOC can constitute an element of addiction therapy when introducing health education to prepare the patient for independent life in sobriety.

Colorectal cancer is one of the most common cancers in Europe and the world. Cancer treatments have side effects and cause significant deterioration of the patient's nutritional status. Patient malnutrition may worsen the health condition and prevent the deliberate effects of the therapy. The aim of this review was to describe the available data about clinical nutrition in colorectal cancer patients. A large proportion of colorectal cancer patients suffer from malnutrition, which negatively affects the survival prognosis, quality of life, and oncological therapy. Therefore, monitoring nutritional status during the treatment is essential and can be used to arrange proper nutritional therapy to enhance patient responses, prevent side effects, and shorten recovery time. The principles of nutrition during anticancer therapy should mainly consider light and low-fat foods, the exclusion of lactose and gluten-containing foods in certain cases, or the introduction of special dietary products such as oral nutrition supplements and it should be tailored to patients' individual needs.

Introduction: Cancer is associated with chronic pain, which significantly reduces the quality of life. The level of pain depends on the dominant pain management strategy that the patient uses., Objective: This study seeks to evaluate the application of the Pain Coping Strategies Questionnaire among cancer patients and develop norms allowing differentiation of patients with diagnosed cancer in terms of pain management strategies., Material and Methods: The study involved 1187 patients diagnosed with malignant cancer, who are under outpatient care of the Maria Sklodowska-Curie Institute-Oncology Center in Warsaw. The study used the Pain Coping Strategies Questionnaire (CSQ) elaborated by A.K. Rosentel and F.J. Keefe., Results: Socioeconomic variables and medical factors affect pain management strategies chosen by patients. The area most strongly differentiated by the studied variables is praying/hoping. Factors that have the greatest impact on the choice of pain management strategies for cancer patients include education, income, and radiation therapy. Sten standards were developed to determine the severity of pain management strategies used in the low-average-high categories., Conclusions: The CSQ questionnaire should be used in cancer patients, and the result of the strategy used can be a prognostic factor for the expected effects of therapy. Knowledge of the variables most strongly affecting patients' choice of strategies that are not conducive to strengthening health attitudes and the ability to determine the severity of pain management strategies on standard scales allows us to focus psychotherapeutic activities on patients who need support most.

The purpose of this article is to examine the applicability of the Beliefs about Pain Control Questionnaire (BPCQ) among cancer patients and develop norms that allow differentiation of patients with diagnosed cancer in terms of beliefs about pain control. Normalization aims to establish the value of test results in the study population. The study involved 1187 patients diagnosed with cancer in outpatient care Maria Sklodowska-Curie Cancer Center and Institute of Oncology, in Warsaw. The applied tool was the Beliefs about Pain Control Questionnaire developed by S. Skevington. The results are most strongly differentiated in each dimension of pain control by education, income, and professional status. Sten norms were developed to determine the level of beliefs about pain control in low, average, and high categories. The BPCQ assessment applies to cancer patients, and the assessment of the location of pain control in patients will allow for the identification of patients whose standard therapy should be supplemented with psychotherapeutic support.

This paper presents a comparative assessment of mortality in Poland and Ukraine, including due to alcohol consumption, by sex, place of residence, and age groups. Mortality from alcohol consumption is and remains one of the health problems of the state's population. The aim of this study was to establish the difference in mortality, including due to alcohol consumption, in the two neighboring countries. The analysis was conducted in 2008 and 2018 according to statistical institutions in Poland and Ukraine. Data from the codes of the International Statistical Classification of Diseases of the 10th edition: F10, G31.2, G62.1, I42.6, K70, K86.0, and X45 were used to calculate mortality due to alcohol consumption. The share of mortality caused by alcohol consumption in Ukraine in 2008 was 3.52%, and 1.83% in 2018. At the same time, in Poland, there is an increase in this cause of death from 1.72% to 2.36%. Mortality caused by alcohol consumption is the main share of mortality in the section "Mental and behavioral disorders" in both Ukraine, at 73-74%, and Poland, at 82-92%. Changes in the mortality rate in the cities and villages of Ukraine and Poland showed different trends: Poland nated, a significant increase in mortality, while in Ukraine it has halved on average. Overall and alcohol mortality rates in both countries were higher among the male population. The analysis of mortality among people of working age showed that the highest proportion of deaths from alcohol consumption in both countries was among people aged 25-44. Despite the geographical proximity, and similarity of natural and climatic characteristics and population, mortality rates in each country reflect the difference in the medical and demographic situation, and the effectiveness of state social approaches to public health.

Introduction: The basic determinant of healthy behaviour-among other human behaviours-is the fact that it consistently affects health. Nowadays, health behaviour studies are considered to be an important method of measuring the health of a population., Objective: To assess the health behaviours and value-based health analysis of people aged 50+ who were hospitalized due to cardiovascular disease, depending on the selected descriptive variables., Materials and Methods: The study was conducted between April 2018 and December 2018 among 411 subjects aged 50+ who were hospitalized due to cardiovascular disease at the Independent Public Health Care Unit in Sanok (Podkarpackie voivodship in Poland). The method used in the study was a diagnostic survey. The study used the authors' survey questionnaire and two standardized tests: Inventory of Health-Related Behaviour (IHB) and List of Health Criteria (LHC). A statistical analysis was carried out in the R program, version 3.5.1. The obtained results were subjected to thorough statistical analysis using the following tests: Student's t , Mann-Whitney U, ANOVA, Kruskal-Wallis, Fisher's Least Significant Difference (LSD), Pearson, and Spearman., Results: The strongest correlation between health status and health behaviours (according to the IHB questionnaire) was in the area of 'health practices', while the lowest correlation was found in the areas of 'correct eating habits' and 'preventive behaviours'. Based on the LHC questionnaire, the most important health criteria according to the subjects were 'not feeling any physical ailments'; 'having all body parts functional'; 'feeling well'; 'eating properly'; and 'infrequent need of going to the doctor'. A positive correlation was found in the group of respondents where the 'preventive health behaviours' were more intense; herein, the more important criterion for the respondents was 'eating properly'., Conclusions: Respondents aged 50+ and hospitalized for cardiovascular diseases indicated (based on the IHB questionnaire) that health behaviours in the area of 'health practices' had the strongest correlation with their health, while the lowest correlation was found in the areas of 'correct eating habits' and 'preventive behaviours'. According to the respondents, the most important criteria determining health (according to the LHC questionnaire) included 'not feeling any physical ailments'; 'having all body parts functional'; 'feeling well'; 'eating properly'; and 'infrequent need of going to the doctor'. Based on the information collected from the respondents, it was found that the most important criteria determining health depended on selected descriptive variables, such as age, gender, place of residence, education, and marital status.

Recently, the outbreak of the SARS-CoV-2 virus and the COVID-19 pandemic significantly affected the health situation of the entire society and necessitated reorganization of health care including oncology. The objective of this study was to examine the perception of medical services by cancer patients during the pandemic and to identify the key elements influencing the level of satisfaction with oncological care. Of note, 394 patients diagnosed with cancer treated in inpatient oncology wards participated in the study (Poland). The diagnostic survey method was used. A survey questionnaire developed by the authors was used and validated the EORTC IN-PATSAT32 questionnaire. The calculations were made in Statistica 10.0 (Statsoft; 2011, Dell Inc., Round Rock, TX, USA). The average general level of satisfaction with oncological care in the study group was 80.77 out of a total score of 100, representing the highest level of satisfaction. Levels of satisfaction varied according to time since diagnosis (longer time-greater satisfaction) and were lower where treatment was delayed or perceived as disorganised. Nearly half of the respondents felt the threat of the SARS-CoV-2 infection, despite the fact that most of them believed that the hospital was well prepared to diagnose and treat cancer patients during the COVID-19 pandemic. Convincing patients about the proper preparation of health care for diagnostics and therapy is an important element influencing patient satisfaction with oncological care.

Introduction: Breast cancer is the most common malignancy in women. Due to the large number of women living with breast cancer and the increasing incidence of this cancer, it is very important to understand the factors determining the quality of life (QOL) of patients., The Aim of the Study: The aim of the study was to determine the impact of time to initiation of treatment on the quality of life of women with breast cancer., Materials and Methods: The study involved 324 women with breast cancer, treated at the Podkarpackie Oncology Centre in Brzozów, Poland. The study was conducted using a diagnostic survey, using a standardised questionnaire to measure the quality of life of women treated for breast cancer, i.e., the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC) QLQ-C30 and the QLQ-BR23 module, as well as a proprietary survey questionnaire. Statistical analysis was performed using the Statistica 10.0 software (StatSoft Inc., 2011). A p value of <0.05 was considered statistically significant., Results: The examined women had a reduced overall quality of life and health (M = 53.88). The quality of life was higher in women who consulted a doctor the earliest after noticing initial symptoms of the disease, i.e., up to one week (M = 57.58), compared to patients who delayed the decision (over four weeks; M = 47.8) ( p = 0.002). The quality of life was also considered higher by women who received treatment within two weeks of diagnosis (M = 56.79) and was lower for patients who waited for treatment for more than two months (M = 43.68). Statistically significant relationships were demonstrated for functional scales and disease intensity., Conclusions: Women diagnosed with breast cancer had a considerably lower overall quality of life. A relatively higher quality of life was experienced by patients who consulted a doctor the earliest after discovering symptoms of the disease and those whose waiting time for treatment was shorter. In a systematic manner, the individual stages of diagnosis should be maximally reduced and breast cancer treatment initiated without delay.

Introduction: In the light of the increased ageing of the world population, social policy needs to be focused on actions aimed at improving the quality of life of older people., Objective: The main objective of this study was to assess the quality of life in a population of seniors hospitalized due to cardiovascular disease., Materials and Methods: The study included 408 elderly patients hospitalized for cardiovascular diseases in the Poddębickie Centrum Zdrowia Hospital in Poddębice, Łódzkie voivodship, Poland. The study used two survey questionnaires: the author's survey questionnaire and the standardized SF36v2 Questionnaire. Statistical analysis of the obtained test results was carried out in the R program, version 3.5.1., Results: Having analyzed the health status of the study group, it was found that the largest group of subjects (84.07%) were treated due to hypertension. Among the ailments that hindered daily functioning, the respondents indicated primarily poor eyesight (53.68%). Patients assessed their own health as 'mediocre' (average) (58.58%). The analysis of the study results from the SF36v2 Questionnaire showed that the highest quality of life was in the limited activity due to emotional problems (RE) dimension, social functioning (SF), and physical functioning (PF); the weakest scores were observed in vitality (VT), general health perception (GH), and health transition (HT) dimensions., Conclusions: The significant demographic, social and socio-medical factors that determined respondents' quality of life were: age, gender, marital status, education and health situation. The analysis of quality of life according to the SF36v2 Questionnaire showed that the study group functioned better in the mental dimension (MCS-mental component summary, overall mental health) than in the physical one (PCS-physical component summary, total physical health)., Competing Interests: The authors declare no conflict of interest.

Introduction: Numerous studies conducted in Europe and worldwide have indicated that employees of hospitality venues are the most exposed professional group to environmental tobacco smoke (ETS) in the workplace. The purpose of this study was to assess the exposure of employees of hospitality venues to ETS in the light of changes in anti-tobacco legislation in Poland. Materials and methods: The study consisted of two stages. The first stage was conducted in 2010, while the second in 2015. The study was conducted among employees of 300 randomly selected hospitality venues in the city of Łódź (Poland). In total, 2607 questionnaires were analysed. The study used two survey questionnaires created and recommended by the Institute for Global Tobacco Control to study exposure to ETS. Statistical analysis was made with Statistica 13.1 PL (StatSoft, Poland). Results: In the group of all nonsmoking employees, individuals exposed to ETS at work in 2010 accounted for 72.6%; while in 2015 it was 51.8%. Factors affecting exposure to ETS in the workplace included, among others: age, marital status, education, position held, presence of a smoking room on the premises, and noncompliance with the provisions of the anti-tobacco laws. Conclusions: The prevalence of tobacco smoking among employees of hospitality venues decreased in 2010-2015, however, it remained high. More than half of nonsmoking employees were exposed to ETS at work.

Introduction: The biggest threat to life are cardiovascular diseases which are a serious problem in Poland, Europe, and worldwide. Therefore, it has become important to have proper health behaviours which significantly eliminate the occurrence and development of cardiovascular diseases., Objective: The main aim of this study is to present factors that determine health behaviours of the 50+ population with cardiovascular diseases., Material and Methods: The study was carried out among 411 individuals aged over 50 with cardiovascular diseases. The method used was a diagnostic survey. The study involved an authors' survey questionnaire and the Inventory of Health-Related Behaviours (IHB). A detailed statistical analysis was carried out in the R programme, version 3.5.1., Results: The most common disease in the study group was coronary heart disease - 63.75%. The majority of respondents showed (via Inventory of Health-Related Behaviour [IHB]) that the level of their health behaviours was moderate - 41.12%; the highest level of health behaviours in the study group were related to health practices, while a slightly lower level was observed in the area of positive mental attitude. Statistical significance was also found between the level of intensity of health behaviours and age, gender, BMI, place of residence, education, professional activity and marital status of the respondents., Conclusions: Anti-health behaviours were predominant among the respondents; significant demographic and social factors determining health behaviour were determined, such as age and gender; a high level of health behaviours was found in the group of women with higher education and correct body mass, living in cities and married.

Objective: The purpose of this study was to estimate the prevalence of presenteeism in patients with communicable diseases in Poland., Subject and Methods: This study was based on data from the medical records of 2,529 patients aged 19-64 years. All of the patients were diagnosed with communicable diseases. The inclusion criteria were based on implementing decision concerning communicable diseases made by the Commission of the European Union. Associations between refusal to take sick leave and patients' age, gender, and diagnosis in terms of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) were tested. Linear regression analysis of the data acquired from the patients who agreed to take sick leave was further used to estimate the possible length of sick leave in patients who refused to take it., Results: The number of patients who refused to take sick leave was 18.1%. The presenteeism rate was related to the age of patients (periods of sick leave were longer in older patients) and the ICD-10 diagnosis (largely in bacterial intestinal infections and measles). The estimated number of days spent on sick leave in patients who refused to take it, assuming that they made a different decision and complied with it, was in the range of 4-6 days., Conclusion: The prevalence of presenteeism in the case of communicable diseases in Poland is lower than in the general population. However, as the refusals to take sick leave took place in the case of potentially contagious diseases, the negative impact on productivity may be significant., (© 2019 The Author(s) Published by S. Karger AG, Basel.)

Background: Breast cancer treatment is an aggressive therapy that affects the deterioration of women's quality of life (QOL) in many areas. Knowledge about factors that influence the assessment of the QOL is of particular importance. The aim of the study was to analyse areas of the quality of life of women with breast cancer, taking into account social and demographic factors., Methods: The research was carried included 324 women with breast cancer. The research was carried out using a diagnostic survey, the author's questionnaire and a standardized questionnaire for measuring the QOL of women treated for breast cancer, ie the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire (EORTC) QLQ-C30 and QLQ-QLQ module BR23. Statistical analysis uses Statistica 10.0 software. The results were considered statistically significant when the calculated probability met the inequality of p.

Breast cancer is the most common malignant tumor in women. The results of breast cancer treatment to a large extent depend on the time of the primary diagnosis of the disease., Aim: The aim of this study was to determine the most common causes of the delay and the delay time in the diagnosis of breast cancer in Polish women., Materials and Methods: The study was performed using a diagnostic survey and analysis of medical documentation from the Subcarpathian Regional Oncology Center, Poland. A total of 231 patients with diagnosed breast cancer were recruited to the study., Results: Delays in diagnosing of breast cancer were found in 83.1% of all the patients. The average time from the first symptom observation by a woman to the first medical consultation was on average 61.7 days. The most common cause of the delay in medical consultation in the examined group was a fear of diagnosing cancer (31.2%)., Conclusions: The examined women require permanent health education in the field of breast cancer and the importance of early diagnosis of the disease for the effectiveness of treatment and prognosis., (© 2019 MEDPRESS.)

Background: Up to now, there have been very few studies concerning delay issues in the treatment of breast cancer in Poland. The aim of the study was to determine the time and causes of delay in the treatment of women diagnosed with breast cancer and the importance of demographic and social factors on the occurrence of delays in the implementation of therapy., Material and Methods: The study was conducted in 2015-2016 in the Podkarpackie Oncology Centre in Brzozów for a group of 231 women. The time criterion of the delays in the treatment of women suffering from breast cancer was more than 1 month from the first oncological consultation to therapy initiation. The diagnostic poll method and medical documentation analysis were used. Research tools included a survey questionnaire and research protocol. The collected material was subjected to the statistical analysis using the χ 2 test. The values of p < 0.05 were considered statistically significant., Results: Delays were noted in 62.8% of the study participants and the mean delay time took 12.6 weeks. The main causes of the delays were: fear that the diagnosis would be confirmed, long waiting time for specialist investigations and their results, age, marital status and professional activity. No statistically significant correlation was found between profession, education level and the place of residence with therapy delays., Conclusions: Delays in the treatment of breast cancer patients were noted in the majority of study participants. A correlation was observed between the delays and chosen sociodemographic factors. Med Pr. 2019;70(1):89-98., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

Introduction: In women diagnosed with breast cancer one of the methods most commonly applied in therapy is surgical treatment, which consists in a breast conserving surgery or total removal of the breast. The applied type of surgical treatment may exert an effect on the satisfaction with life of the women., Objective: The aim of the study was evaluation of the satisfaction with life among women surgically treated for breast cancer, according to the type of surgery on the breast, and the time elapsed since its performance., Material and Methods: The study included 121 patients of the Sub-Carpathian Oncology Centre in Brzozów, south-east Poland, who had undergone surgical treatment due to breast cancer. The women expressed their informed consent to participate in the study. The method of a diagnostic survey was applied., Results: The women obtained a mediocre result in satisfaction with life - 5.64 sten scores. Patients who had undergone mastectomy had a considerably lower level of satisfaction with life, compared to those after breast-conserving surgery (4.73 sten scores vs. 6.30 sten scores). Evaluations of the satisfaction with life in the examined group significantly differed according to the time elapsed since performance of surgery., Conclusions: There is a need for undertaking actions directed to women who have undergone surgical treatment for breast cancer within the period from 2-5 years, aimed at improving the satisfaction with life in this group of patients. In addition, special support should be provided for women who have undergone mastectomy, especially during the period of more than 1 and up to 2 years.

Objective: The aim of the study was evaluation of satisfaction with life among women ill with breast cancer, with consideration of selected demographic and social factors., Material and Methods: In the study participated 121 patients from the Sub-Carpathian Oncology Centre in Brzozów, Poland, who had undergone surgical treatment due to breast cancer. The method of a diagnostic survey was used. The research instruments were an author-constructed questionnaire and the Satisfaction with Life Scale., Results: Women who received surgical treatment due to breast cancer evaluated their satisfaction with life on a mediocre level. Younger patients had a lower satisfaction with life than those who were older. Women living in urban areas evaluated their satisfaction with life in more positive terms than rural women. In turn, education level, marital status and material standard had no effect on the level of satisfaction with life among the women in the study., Conclusions: According to the SWLS, women with the diagnosis of breast cancer obtained a mean result of 5.64 sten scores Younger women evaluated their satisfaction with life in more positive terms than those who were older. Women who lived in urban areas obtained a considerably higher result according to the SWLS, compared to rural inhabitants. Marital status, education level, material standard and occupational activity of the women were insignificant in the respondents' evaluation of satisfaction with life.

Chromium is an essential microelement in the human body. It exerts an effect on bones by modulating their biochemical parameters: alkaline phosphatase (ALP) and tartrate-resistant acid phosphatase (TRAP). With considerable accumulation of chromium in the skeleton, the activity of alkaline phosphatase was found to decrease, which affected bone formation rate. The study objective was to analyze chromium content in the knee tissues. Tissues for analysis were obtained during endoprosthesoplasty of the knee joint and included tibia, femur, and meniscus tissues. Samples were collected from 50 patients, including 36 women and 14 men. The analysis was performed using the inductively coupled plasma atomic emission spectroscopy (ICP-AES) method, by means of a Varian 710-ES apparatus. The results revealed no significant differences in the content of chromium in the knee joint tissues between women and men. The highest level of chromium was found in the femoral bone of the knee joint, then in the meniscus, and was lowest in the tibia, although the differences were statistically insignificant. Chromium content increased with age.

Introduction: Despite great progress in the diagnostics and treatment, breast cancer still remains the most frequently diagnosed malignant cancer in women. The outcomes of cancer treatment depend, to a considerable extent, on the degree of acceptance of the illness. The objective of the study was determination of the level of acceptance of the disease among the examined women with breast cancer., Material and Methods: The study covered a group of 231 women who received treatment for breast cancer in the Rev. Bronislaw Markiewicz Subcarpathian Oncology Centre in Brzozow, south-eastern Poland, and conducted by the method of a diagnostic survey, using an author constructed questionnaire and the standard Acceptance of Illness Scale, adapted by Z. Juczyński. Statistical analyses were performed using the software IBM SPSS v. 21.0.0.1. The p values p≤0.05 were considered statistically significant., Results: The mean level of acceptance of the illness in the examined group of women was 26.53 (SD = 7.71; Me = 26). The largest number of respondents (50.6%) obtained scores within the range of 20-29, according to the AIS Scale. From among the adopted variables, the level of acceptance of the illness significantly varied according to age and occupational activity. However, no such differences were confirmed according to the place of residence, marital status, education level, or the type of occupation performed., Conclusions: In the examined group of women, a mediocre level of acceptance of cancer was observed. The respondents' age and occupational situation exerted a significant effect on the level of acceptance of the illness. The results of the study should be considered as satisfactory because the number of women with a high level of acceptance of breast cancer was more than twice as high as those ones with a low acceptance of the disease.

Many elements are responsible for the balance in bone tissue, including those which constitute a substantial proportion of bone mass, i.e., calcium, phosphorus and magnesium, as well as minor elements such as strontium. In addition, toxic elements acquired via occupational and environmental exposure, e.g., Pb, are included in the basic bone tissue composition. The study objective was to determine the content of strontium, lead, calcium, phosphorus, sodium and magnesium in chosen components of the knee joint, i.e., tibia, femur and meniscus. The levels of Sr, Pb, Ca, P, Na and Mg were the highest in the tibia in both men and women, whereas the lowest in the meniscus. It should be noted that the levels of these elements were by far higher in the tibia and femur as compared to the meniscus. In the components of the knee joint, the level of strontium showed the greatest variation. Significant statistical differences were found between men and women only in the content of lead.

Osteoarthritis causes the degradation of the articular cartilage and periarticular bones. Trace elements influence the growth, development and condition of the bone tissue. Changes to the mineral composition of the bone tissue can cause degenerative changes and fractures. The aim of the research was to determine the content of cadmium (Cd), nickel (Ni), copper (Cu) and zinc (Zn) in the tibia, the femur and the meniscus in men and women who underwent a knee replacement surgery. Samples were collected from 50 patients, including 36 women and 14 men. The determination of trace elements content were performed by ICP-AES method, using Varian 710-ES. Average concentration in the tissues of the knee joint teeth amounted for cadmium 0.015, nickel 0.60, copper 0.89 and zinc 80.81 mg/kg wet weight. There were statistically significant differences in the content of cadmium, copper and zinc in different parts of the knee joint. There were no statistically significant differences in the content of cadmium, nickel, copper and zinc in women and men in the examined parts of the knee joint. Among the elements tested, copper and nickel showed a high content in the connective tissue (the meniscus) compared to the bone tissue (the tibia and the femur).

Objectives: Stimulation of some noradrenergic system receptors demonstrates a synergistic anti-nociceptive effect with the opioid system at the level of peripheral tissues, spinal cord, and supraspinal structures. Furthermore, opioids stimulate the noradrenergic descending pathways originating from the substantia nigra by presynaptic inhibition of the GABA neuron ends. It is thus important to determine whether a disruption to the adrenergic transmission obtained via DPS-4 administration to neonatal rats impacts the perception of noxious stimuli mediated by 5-HT3-serotonin receptors at the level of spinal cords or higher tiers of the central nervous system., Design & Setting: The studies were conducted with neonatal and adult rats, males of the Wistar strain in which a central noradrenergic system lesion was induced with DSP-4 on days 1 and 3 of life. Next, the evaluation of the analgesic effect of morphine was performed on 8- to 10-week-old animals using the following models of acute nociceptive pain: the hot plate test and the tail immersion test as models of acute nociceptive pain induced by a thermal stimulus, and the paw withdrawal test as a model of nociceptive pain caused by a mechanical stimulus., Results: Morphine was found to produce a longer-lasting analgesic effect in the tail immersion test in the control group than in rats. Similarly, in the paw withdrawal test, this substance generated a strong analgesic effect (with over 200% of analgesia) in the control group, whereas its action in the rats with DSP-4 lesions was statistically significant. Morphine induced analgesia at about 13-14% in the control rats when examined with the hot plate test., Conclusions: The disruption to the central noradrenergic system in an early stage of development resulted in a reduction of the analgesic effect of morphine in the models of acute pain in which the mechanisms of supraspinal perception are involved.

Introduction: Since little has been known about the effect of the central noradrenergic system on the reactivity of serotonin 5-HT3 receptors, the aim of the current study was to find out whether this reactivity could be altered by chemical damage to the system in adult rats in early developmental stage., Materials and Methods: Adult male Wistar rats with central noradrenergic lesion induced by DSP-4 on day 1 and 3 of life were injected with analgesic model substance - morphine, serotoninergic 5-HT3 receptor agonist (1-phenylbiguanide, PBG), 5-HT3 receptor antagonist (ondansetron) or both compounds jointly followed by decarboxylase inhibitor of aromatic amino acids (NSD-1050). After 30 min following NSD-1050 injection, the animals were decapitated using a guillotine. Chosen cerebral structures were dissected, and the contents of 5-hydroxytryptofan (5-HTP) and l-dihydroxyphenylalanine (l-DOPA) were determined using high-pressure liquid chromatography with electrochemical detection (HPLC/ED)., Results: Neither PBG nor morphine affected l-DOPA contents in the hippocampus in control rats; however, DSP-4 lesion caused a significant decrease in the synthesis rate of DA in this structure. Hippocampal contents of 5-HTP increased after morphine or PBG administration, and central noradrenergic lesion attenuated this effect. Morphine or PBG decreased cerebellar DA synthesis rate in control rats and DSP-4 lesion did not modify it. Cerebellar levels of 5-HTP increased after morphine or PBG challenge in control rats. DSP-4 lesion intensified the effect of morphine and attenuated that of PBG. Ondansetron abolished the effects mediated by PBG. We did not observe any impact of PBG or ondansetron on DA and 5-HT synthesis in the striatum., Conclusion: Damage to the central noradrenergic system in rat newborns, through altered reactivity of central 5-HT3 receptors, results in permanent disorders in serotoninergic transmission in hippocampus and cerebellum as well as dopaminergic transmission in hippocampus, which may attenuate the activity of the descending pathways that derive from these structures., (Copyright © 2014 Institute of Pharmacology, Polish Academy of Sciences. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.)

Background: Some aspects of the pathophysiology of complications in multiple-trauma patients still remain unclear. Mediators of inflammation have been postulated as playing a key role in being responsible for life threatening complications of multiple trauma patients. The objective of this study was to evaluate the prognostic value of procalcitonin (PCT) level in multiple trauma patients., Methods: A prospective study took place including patients with multiple trauma hospitalised in several hospital units. PCT level was measured in blood from 45 patients, aged 18-70 years using enzyme-linked immunoassay. The patients were divided into three groups: group I - individuals with multiple trauma with central nervous system injury; group II - those with multiple trauma without CNS injury; and group III - patients with isolated central nervous system injury., Results: Initial PCT levels were below 0.5 ng mL(-1) regardless of the cause of trauma. In the 24th hour of observation, a statistically significant increase of PCT concentration vs. initial levels was recorded in all groups of patients. Then PCT levels decreased significantly at the 3rd measurement point in all groups, and they remained unchanged until the last measurement. The highest levels of PCT were observed in multiple trauma patients without CNS injury (group II). In this group of patients, a significantly longer duration of surgery in the post-trauma period affected PCT levels. PCT concentrations in patients who died were significantly greater than in survivors., Conclusions: A long lasting elevated concentration of procalcitonin in the post-traumatic period, or its repeated increase, is a good marker of developing complications observed earlier than clinical manifestations.