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Magdalena Jachymek,1 Łukasz Wójcik,2 Małgorzata Peregud-Pogorzelska,1 Miłosz Parczewski,3 Aneta Dembowska,3 Bogusz Jan Aksak-Wąs3 1Department of Cardiology, Pomeranian Medical University, Szczecin, 70-111, Poland; 2Department of Radiology, Pomeranian Medical University, Szczecin, 70-111, Poland; 3Department of Infectious, Tropical Diseases and Immune Deficiency, Pomeranian Medical University, Szczecin, 71-455, PolandCorrespondence: Bogusz Jan Aksak-Wąs, Department of Infectious, Tropical Diseases and Immune Deficiency, Pomeranian Medical University, Szczecin, 71-455, Poland, Email bogusz.aksak.was@pum.edu.plPurpose: People living with HIV are twice as likely to develop cardiovascular diseases (CVDs) and myocardial infarction related to atherosclerosis than the uninfected population. This study aimed to evaluate the prevalence of subclinical atherosclerosis in a young, mid-eastern European population of PLWH receiving ART for undetectable viremia.Patients and Methods: This was a single-centre study. We included 34 patients below 50 years old, treated in Szczecin, Poland, with confirmed HIV-1 infection, treated with antiretroviral therapy (ART), and undetectable viremia. All patients underwent coronary artery computed tomography (CACT), carotid artery intima-media thickness (IMT) evaluation, and echocardiography.Results: In the primary assessment, only two (5.8%) patients had an increased CVD risk calculated using the Framingham Risk Score (FRS), but we identified coronary or carotid plaques in 26.5% of the patients. Neither traditional risk factors nor those associated with HIV significantly influenced the presence of the plaque. IMT was significantly positively correlated with age and the FRS (R=0.38, p=0.04). Relative wall thickness assessed in echocardiography was higher in those with plaque (0.49 vs 0.44, p=0.04) and significantly correlated with IMT (R=0.38, p=0.04).Conclusion: In our population, more than a quarter of PLWH with undetectable viremia had subclinical atherosclerosis in either the coronary or carotid arteries. The FRS underpredicted atherosclerosis in this population. The role of RWT as a possible early marker of atherosclerosis needs further studies.Keywords: cardiovascular disease, echocardiography, coronary artery computed tomography, intima media thickness, people living with human immunodeficiency virus

Abstract Triple-negative breast cancer (TNBC) represents aggressive phenotype with limited treatment options due to the lack of drug targets. Natural compounds are extensively studied regarding their potential to alter the efficacy of cancer treatment Among them sulforaphane – an isothiocyanate of natural origin, was shown to be a hormetic compound, that may exert divergent effects: cytoprotective or cytotoxic depending on its concentrations. Thus, the aim of this study was to determine the effect of its low, dietary concentrations on the proliferation and migration of the TNBC cells in the in vivo and in vitro 2D and 3D model. Results of the in vivo experiment showed up to 31% tumor growth inhibition after sulforaphane treatment associated with lowered proliferating potential of cancer cells, reduced areas of necrosis, and changed immune cell type infiltration, showing less malignant type of tumor in contrast to the non-treated group. Also, the study revealed that sulforaphane decreased the number of lung metastases. The in vitro study confirmed that SFN inhibited cell migration, but only in cells derived from 3D spheroids, not from 2D in vitro cultures. The results show a specific role of sulforaphane in the case of cells released from the TNBC primary tumor and its environment.

Background: The COVID-19 pandemic has placed an enormous strain on the healthcare system, including infection prevention and control. The response to the COVID-19 pandemic required extraordinary resources, which were often diverted from routine infection prevention and control activities and may have contributed to increased rates of HAI in the acute care setting. However, the impact of the COVID-19 pandemic on infection prevention and control departments, including staffing and resources, and on routine infection prevention and control activities is not well-described. The objective of this study was to describe the impact of the COVID-19 pandemic on IPC departments and department response to the pandemic. Methods: Between August and December of 2023, we conducted an electronic survey of all acute care facilities participating in the National Healthcare Safety Network. Survey data were analyzed using descriptive statistics. Results: Over 594 infection control departments participated in the survey, representing 1,400 NHSN facilities (20% response rate based on number of eligible NHSN facilities). Half of the respondents reported that their hospital experienced increases in the following HAI rates during the first two years of the pandemic: central-line associated bloodstream infections (54%), catheter-associated urinary tract infections (46%) and ventilator associated pneumonia (45%). When asked to identify the top three contributors to increased HAI rates in their facility, respondents cited the following factors: staffing shortages (70%), patient acuity (69%), use of travel nurses (48%), increased device utilization (37%), and reduced bedside acuity (31%). Respondents reported that their department utilized the following actions to decrease these HAI rates: increased rounding and monitoring of IPC procedures (81%), reeducation of frontline staff on IPC policies and procedures (77%), environmental care rounds (69%), monitoring of isolation compliance (66%), HAI Task Force/Committee (57%), nurse-driven catheter removal protocols (53%), and insertion prevention protocols (53%). When asked if the department experienced applied pressure or attempts to influence HAI reporting due to the increase in HAI rates in the facility experienced in the wake of the pandemic, 19% of respondents reported increased pressure from management/C-suite and 7% reported increased pressure from providers. Conclusion: The COVID-19 pandemic had a substantial impact on IPC departments in acute care hospitals and had a profound effect on IPC staffing, resources and routine IPC activities. Future work needs to identify best practices and lessons learned from the pandemic to inform future pandemic preparedness.

Z roku na rok rośnie liczba osób, u których diagnozuje się spektrum autyzmu. Problem ten nie dotyczy tylko naszego kraju, ale ma zasięg globalny. Dlatego należy przygotować systemy pracujące na rzecz obywateli, tj. system opieki społecznej, edukacji, aktywizacji zawodowej, jak również rynek pracy do przyjmowania coraz większej liczby osób z autyzmem. Niestety, dostępne obecnie statystyki mówią o braku koordynacji i efektywności działań pomocowych, o niewielkim ich zasięgu czy o braku zainteresowania rynku pracy tymi osobami.

Abstract Chronic thromboembolic pulmonary hypertension (CTEPH) is a disease resulting from impaired patency of the pulmonary arteries by a clot, and the treatment method of choice is pulmonary endarterectomy (PEA). In inoperable patients, balloon pulmonary angioplasty (BPA) is recommended, but we need to implement pharmacological bridge therapy to BPA in some cases. We report a case of a 38‐year‐old male diagnosed with CTEPH, disqualified from PEA due to comorbidity, who developed right ventricular (RV) failure. The case shows a complex pharmacological treatment method that can be successfully used as an effective bridge therapy to BPA in patients with CTEPH and severe RV dysfunction, disqualified from surgery.

Research objectiveThe COVID-19 pandemic disrupted healthcare delivery worldwide with likely negative effects on people who use opioids (PWUO). This scoping review of the original research literature describes the impact of the COVID-19 pandemic on healthcare delivery for PWUO and identifies gaps in the literature.MethodsThis scoping review of the original research literature maps the available knowledge regarding the impact of the COVID-19 pandemic on healthcare delivery for PWUO. We utilized the methodology developed by the Joanna Briggs Institute for scoping reviews, and content analyses methodology to characterize the current state of the literature.ResultsOf the 14 included studies, administrative database (n = 11), cross-sectional (n = 1) or qualitative (n = 2) studies demonstrated service gaps (n = 7), patient/provider experiences (n = 3), and patient outcomes for PWUO (n = 4). In March 2020, healthcare utilization dropped quickly, sharply increasing only for reasons of opioid overdose by May 2020. Service gaps existed in accessing treatment for new patients during the pandemic due to capacity and infrastructure limits. Physicians reported difficulty referring patients to begin an outpatient opioid treatment program due to increased restrictions in capacity and infrastructure. Patients also reported uncertainty about accessing outpatient treatment, but that telehealth initiation of buprenorphine increased access to treatment from home. Disproportionate increases in overdose rates among African Americans were reported in two studies, with differences by race and gender not examined in most studies. Fatal overdoses increased 60% in African Americans during the pandemic, while fatal overdoses in Non-Hispanic White individuals decreased.ConclusionsIn summary, this beginning evidence demonstrates that despite early reluctance to use the healthcare system, opioid overdose-related use of healthcare increased throughout the pandemic. Service delivery for medications to treat OUD remained at or above pre-pandemic levels, indicating the ability of telehealth to meet demand. Yet, racial disparities that existed pre-pandemic for PWUO are intensifying, and targeted intervention for high-risk groups is warranted to prevent further mortality. As the pandemic progresses, future research must focus on identifying and supporting subgroups of PWUO who are at heightened risk for experiencing negative outcomes and lack of access to care.

The leaves of Ilex paraguariensis (known as Yerba mate), used as a popular beverage, are a very well-recognized plant material with various biological activities, including analeptic (because of caffeine), anti-obesity (phenolics, saponins), antimicrobial, and antiviral (phenolics, saponins). Here, the chemical compositions of the leaves of two European Ilex species (× meserveae and aquifolium) with three varieties each were investigated. The terpenoid, saponin, and polyphenolic fractions were submitted for LC-MS or GC-MS analysis against a standard Mate leaf. In addition, the aroma profiles of all the species were analysed using HS-SPME-Arrow prior to GC-MS analysis. All fractions were subjected to antiviral and cytotoxic assays. We found 86 compounds in all accessions, with limonene, linalool, and p-cymene being predominant. There were minor similarities between the volatile compositions of the European and South American species. We found ursolic and oleanolic acid to be the main compounds in the terpenoid fraction. Mono-caffeoylquinic acids and di-caffeoylquinic acids were the main constituents of the polar fractions. About 180 compounds from the saponin group were tentatively identified, of which 9 and 3 were selected as distinctive markers for I. meserveae and I. aquifolium, respectively. Based on chemical screening, I. aquifolium Silver Queen was chosen as the source of terpenoid and saponin fractions and polyphenol extracts. The most substantial inhibition of cancer cell growth was observed with saponin in the case of the MCF7 (human breast cancer) cell line, while for LoVo and L929 cell lines (human colorectal cancer and reference mouse fibroblasts), it was slightly weaker. These results should be analysed further as a promising chemoprevention of colorectal and gastrointestinal cancers. Saponin and polyphenolic extracts exhibited similar activities against HSV-1 and HAdV-5, with 4-log reduction in virus titres. This study focuses our attention on a field of potential antiviral formulations derived from European holly.

Abstract Background Recent studies revealed that alterations in glucose and lipid metabolism in idiopathic pulmonary arterial hypertension (IPAH) are associated with disease severity and poor survival. However, data regarding the impact of diabetes mellitus (DM) on the prognosis of patients with IPAH remain scarce. The aim of our study was to determine that impact using data from a national multicentre prospective pulmonary hypertension registry. Methods We analysed data of adult patients with IPAH from the Database of Pulmonary Hypertension in the Polish population (BNP‑PL) between March 1, 2018 and August 31, 2020. Upon admission, clinical, echocardiographic, and haemodynamic data were collected at 21 Polish IPAH reference centres. The all-cause mortality was assessed during a 30-month follow-up period. To adjust for differences in age, body mass index (BMI), and comorbidities between patients with and without DM, a 2-group propensity score matching was performed using a 1:1 pairing algorithm. Results A total of 532 patients with IPAH were included in the study and 25.6% were diagnosed with DM. Further matched analysis was performed in 136 patients with DM and 136 without DM. DM was associated with older age, higher BMI, more advanced exertional dyspnea, increased levels of N-terminal pro–brain natriuretic peptide, larger right atrial area, increased mean right atrial pressure, mean pulmonary artery pressure, pulmonary vascular resistance, and all-cause mortality compared with no DM. Conclusions Patients with IPAH and DM present with more advanced pulmonary vascular disease and worse survival than counterparts without DM independently of age, BMI, and cardiovascular comorbidities.

Problematyka kształcenia zawodowego jest stale obecna w dyskursach i literaturze pedagogiki pracy. W różnych formach to środowisko naukowe prezentuje własne stanowiska, tezy, modele rozwiązań, ideologie, nawiązujące do rozmaitych problemów tego obszaru edukacyjnego. Mowa w nich m.in. o warunkach humanizacji procesów kształcenia zawodowego i zachowaniu równowagi pomiędzy kształceniem instrumentalnym i kierunkowym, holistycznym modelu kształcenia i przygotowaniu absolwentów szkół itd. Tymczasem w praktyce wyraźne są oznaki zmierzania ku racjonalności rynkowej i skrajnej efektywności ekonomicznej tych placówek oświatowych, którą mierzy się głównie oceną zewnętrzną.

The popularity of the use of accessories supporting baby caring such as rockers, car seats, baby carriers, and walkers is defined as container culture or container lifestyle. There is a tendency to use such items incorrectly, often leaving the infant without parental supervision. Reduction of a child’s spontaneous motor activity, prolonged stay in a forced supination position, premature sitting, or premature standing cause disturbances in motor, cognitive, social, and emotional development. The aim of the study is to present the problem of container baby syndrome. We would like to present recommendations that can be used during the parents’ education, to raise their awareness of proper conduct and stimulation of their child’s development.

The present study aimed to investigate the effect of mineral (sulphate) or organic (glycine chelate) forms of Zn used in quantities covering 100% or 50% of the Zn requirement on the fatty acid profile of the thigh muscles of Ross 308 broiler chickens. We also analysed the dietary value of this meat based on its fatty acid profile. The experimental factors did not influence the content of basic chemical components and the meat’s pH. Although, in terms of statistics, the presented study supports the statement that the form (sulphate vs. glycine chelate) and/or amount of Zn used (100% or 50% of the requirement) affects the fatty acid profile and dietary value of thigh meat, the results imply that the requirement of Ross 308 broiler chickens for Zn was also covered in full when in it was used in amounts covering 50% of the requirement, irrespective of the form in which Zn was used. However, it cannot be explicitly confirmed that the form of Zn affects the analysed parameters of thigh meat.

This paper describes the effects of murine norovirus (MNV) infection on oxidative stress and histopathological changes in mice. This study uses histopathological assays, enzymatic and non-enzymatic antioxidant markers, and total oxidative status and capacity (TOS, TAC). The results suggest that MNV infection can lead to significant changes with respect to the above-mentioned parameters in various organs. Specifically, reduced superoxide dismutase (SOD), Mn superoxide dismutase (MnSOD), catalase (CAT), and glutathione reductase (GR) activities were observed in liver tissues, while higher MnSOD activity was observed in kidney tissues of MNV-infected mice when compared to the control. GR activity was lower in all tissues of MNV-infected mice tested, with the exception of lung tissue. This study also showed that norovirus infection led to increased TOS levels in the brain and liver and TAC levels in the brain, while TOS levels were significantly reduced in the kidneys. These changes may be due to the production of reactive oxygen species (ROS) caused by the viral infection. ROS can damage cells and contribute to oxidative stress. These studies help us to understand the pathogenesis of MNV infection and its potential effects on oxidative stress and histopathological changes in mice, and pave the way for further studies of the long-term effects of MNV infection.

The changes that affect almost all areas of modern man's life mean that he is faced with challenges that no one has experienced before. Hence, great hopes are placed on education and its institutions, where young generations will be prepared for changes in the future. Unfortunately, as stated by a large group of educational experts, the Polish school remains in the old pattern of functioning and does not meet the needs of young generations. Therefore, the necessary and urgent task of Polish education is to search for new educational models in which the student will not only be able to use their creative potential and their strengths, but also overcome their own limitations and weaknesses. The educational scenarios presented in the text were inspired by the following reports: OECD Schooling Scenarios in Brief 2007; Poland 2030, 2009; Education of the Future, 2020, et al.

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Introduction: Basal cell carcinoma (BCC) localized in the H-zone, the region of fusion of embryonic masses, has been associated with a higher risk of deeper invasion and more frequent recurrence. Objectives: The aim of the study was to compare dermoscopic features of BCC in H and non-H zone that may most appropriately characterize those two locations. Methods: Dermoscopy images of histopathologically confirmed BCCs from 120 patients were retrospectively analyzed. Dermoscopy features of BCC in H- and non-H zone were described and a comparative study of the dermoscopic pattern of BCC between the two locations was performed. Results: Of 120 BCC cases included in this study, 41 (34.2%) were located in the H-zone. The most frequent histological type was nodular (51.3% in H- zone and 61.6 % in non-H-zone) followed by superficial (5.1% and 19.8 % in H and non-H-zone respectively). In dermoscopy, there was a higher prevalence of ulceration (73.2% versus 43.6%, P < 0.001) in H-zone and a lower prevalence of brown globules (26.8% versus 53.2%; P = 0.01), when compared with the non-H-zone. Conclusions: Our results show that dermoscopic features of BCC on the face fulfill a typical pattern regardless of the region, except for the prevalence of the ulceration which is significantly more frequent in H-zone and the brown globules present significantly more often in the non-H-zone It can be hypothesized that H-zone might predispose to more aggressive course of BCC complicated by ulceration and consequently deeper tissue destruction.

Human adenovirus 36 (HAdV-D36) is presently the sole virus identified to be associated with an elevated risk of obesity in both humans and animals. However, its impact on embryonated chicken eggs (ECEs) remains unexplored. This study endeavoured to examine the influence of HAdV-D36 on embryonic development by utilizing embryonated chicken eggs as a dynamic model. To simulate various infection routes, the allantoic cavity and the yolk sac of ECEs were inoculated with HAdV-D36. Subsequently, embryos from both the experimental (inoculated with virus) and control (inoculated with PBS) groups were weighed and subjected to daily histological examination. The daily embryo weights were assessed and compared between groups using the Shapiro–Wilk test. Histopathological changes in tissues were examined and compared between the tested and control groups to ascertain physiological alterations induced by the virus. Our study confirmed a significant increase in the body weight of ECEs. However, this phenomenon was not attributable to adipose tissue development; rather, it was characterized by an augmented number of cells in all observed tissues compared to control subjects. We posit that HAdV-D36 may impact developing organisms through mechanisms other than enhanced adipose tissue development. Specifically, our findings indicate an increased number of cells in all tissues, a phenomenon that occurs through an as-yet-unexplored pathway.

Female breast cancer is the most deadly cancer in women worldwide. The triple-negative breast cancer subtype therapies, due to the lack of specific drug targets, are still based on systemic chemotherapy with doxorubicin, which is burdened with severe adverse effects. To enhance therapeutic success and protect against systemic toxicity, drug carriers or combination therapy are being developed. Thus, an innovative liposomal formulation containing doxorubicin and the main nutraceutical, sulforaphane, has been developed. The anticancer efficacy and safety of the proposed liposomal formulation was evaluated in vivo, in a 4T1 mouse model of triple-negative breast cancer, and the mechanism of action was determined in vitro, using triple-negative breast cancer MDA-MB-231 and non-tumorigenic breast MCF-10A cell line. The elaborated drug carriers were shown to efficiently deliver both compounds into the cancer cell and direct doxorubicin to the cell nucleus. Incorporation of sulforaphane resulted in a twofold inhibition of tumor growth and the potential of up to a fourfold reduction in doxorubicin concentration due to the synergistic interaction between the two compounds. Sulforaphane was shown to increase the accumulation of doxorubicin in the nuclei of cancer cells, accompanied by inhibition of mitosis, without affecting the reactive oxygen species status of the cell. In normal cells, an antagonistic effect resulting in less cytotoxicity was observed. In vivo results showed that sulforaphane incorporation yielded not only cardioprotective, but also nephro- and hepatoprotective effects. The results of the research revealed the prospects of applying sulforaphane as a component of liposomal doxorubicin in triple-negative breast cancer chemotherapy.

To examine the association between demographic characteristics (i.e., gender, race, age, and years of experience), burnout, and nurses' intent to leave their jobs during the first wave of COVID‐19 in New Jersey. COVID‐19 has exacerbated burnout and intent to leave among acute care nurses. Nonetheless, little is known about demographic factors contributing to nurses' desire to leave their jobs. A cross‐sectional survey of actively licensed registered nurses who provided direct patient care in an acute care hospital in New Jersey during COVID‐19. Among 2760 nurses, those who reported burnout were 4.78 times more likely to report intent to leave their job within 1 year as compared to nurses who did not report burnout. Black RNs were 2.06 times more likely to report intent to leave as compared to White RNs. Older nurses (aged 40–49) were 36% less likely to report intent to leave as compared to younger nurses (aged 21–29). RNs with 30 years of experience or more were 58% less likely to report intent to leave as compared to RNs with less than 5 years of experience. In addition, Black RNs with 6–12 years of experience were 2.07 times more likely to report intent to leave as compared to White RNs with less than 5 years of experience. Nurses' intent to leave during the first wave of the pandemic was influenced by burnout, race, age, and years of experience. Based on the results of the current study, Black nurses were more likely to report intent to leave their job within 1 year as compared to White RNs. Nurses' intention to leave is one of the most important global issues facing the healthcare system. Findings of the current study demonstrate that burnout, race, age, and years of experience are significant predictors of nurses' intent to leave their jobs. Therefore, organizations should prioritize strategies to reduce burnout and create diverse and inclusive work environments. [ABSTRACT FROM AUTHOR]

Simple Summary: The scarcity of specific clinical and dermoscopic criteria makes solitary pink skin lesions the most challenging to diagnose. Cherry angioma, clear cell acanthoma, dermal nevus, keloid, hypertrophic scar, and Spitz nevus are the most common benign lesions that share similar clinical and dermoscopic features. Furthermore, some malignant lesions, such as basal cell carcinoma, actinic keratosis, or amelanotic melanoma, can be indistinguishable from the above-mentioned benign pinkish lesions. Several studies have demonstrated the excellent diagnostic accuracy of reflectance confocal microscopy in increasing sensitivity and specificity compared to dermoscopy alone for the diagnosis of skin cancer. This study aimed to summarize the application of dermoscopy and RCM for the differential diagnosis of benign and malignant pinkish–reddish skin lesions, although, in suspicious lesions, the final diagnosis should always be confirmed after surgical excision and histopathological evaluation. Diagnosing solitary pink skin lesions poses a significant challenge due to the scarcity of specific clinical and dermoscopic criteria. Several benign lesions, such as cherry angioma, clear cell acanthoma, dermal nevus, keloid, hypertrophic scar, and Spitz nevus, often exhibit similar clinical and dermoscopic features. This similarity extends to some malignant lesions, including basal cell carcinoma, actinic keratosis, and amelanotic melanoma, making differentiation difficult. Recent studies highlight the enhanced diagnostic accuracy of reflectance confocal microscopy (RCM), which offers increased sensitivity and specificity compared to dermoscopy alone for diagnosing skin cancer. This study aims to summarize the application of dermoscopy and RCM in distinguishing between benign and malignant pinkish–reddish skin lesions. The integration of RCM with traditional dermoscopic techniques improves the ability to accurately identify and differentiate these lesions. However, it is crucial to note that for any suspicious lesions, a final diagnosis must be confirmed through surgical excision and histopathological evaluation. This comprehensive approach ensures accurate diagnosis and appropriate treatment, highlighting the importance of combining advanced imaging techniques in clinical practice. [ABSTRACT FROM AUTHOR]

Aim: To develop a framework for understanding the stress appraisal process among acute care nurses during the COVID‐19 pandemic. Design: A secondary analysis of open‐ended responses from a cross‐sectional survey of 3030 frontline, acute care nurses in New Jersey and the effect of burnout during the COVID‐19 pandemic. Methods: Lazarus and Folkman's transactional model of stress and coping guided the study. Thematic analysis was used to analyse 1607 open‐ended responses. Results: Nine themes emerged during the secondary appraisal of stress. Five themes contributed to distress and burnout including (1) high patient acuity with scarce resources, (2) constantly changing policies with inconsistent messaging, (3) insufficient PPE, (4) unprepared pandemic planning and (5) feeling undervalued. Four themes led to eustress and contributed to post‐traumatic growth including (1) team nursing to ensure sufficient resource allocation, (2) open channels of communication, (3) sense‐ of‐duty and (4) personal strength from new possibilities. Conclusion: The COVID‐19 pandemic was a traumatic event for patients and the nursing workforce. Internal and external demands placed on acute care nurses increased burnout, however, a subset of nurses with adequate support experienced personal growth. Implications for the Profession and/or Patient Care: Beyond mental health interventions for acute care nurses, organizational interventions such as reevaluation of emergency action plans to optimize resource allocation, and work environment strategies such as improved communication and decision‐making transparency are necessary. Impact: To better understand how frontline acute care nurses experienced stress during COVID‐19, a data‐informed framework was developed that included a primary and secondary appraisal of stress. Themes contributing to distress and burnout were identified, and themes leading to eustress and post‐traumatic growth were also identified. These findings can assist nurse leaders in optimizing strategies to reduce burnout and promote post‐traumatic growth in the post‐COVID years. Reporting Method: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Porokeratosis is a heterogeneous group of keratinising disorders characterised by the presence of particular microscopic structural changes, namely the presence of the cornoid lamella. This structure develops as a consequence of a defective isoprenoid pathway, critical for cholesterol synthesis. Commonly recognised variants include disseminated superficial actinic porokeratosis, disseminated superficial porokeratosis, porokeratosis of Mibelli, palmoplantar porokeratosis (including porokeratosis palmaris et plantaris disseminata and punctate porokeratosis), linear porokeratosis, verrucous porokeratosis (also known as genitogluteal porokeratosis), follicular porokeratosis and porokeratoma. Apart from the clinical presentation and epidemiology of each variant listed, this review aims at providing up-to-date information on the precise genetic background, introduces imaging methods facilitating the diagnosis (conventional and ultraviolet-induced fluorescence dermatoscopy, reflectance confocal microscopy and pathology), discusses their oncogenic potential and reviews the literature data on the efficacy of the treatment used, including the drugs directly targeting the isoprenoid–mevalonate pathway.

The purpose of this study was to investigate the effect of Nigella sativa L. (NS) oil addition on the quality of ground pork for pâté stored for one month and two months (−20 ± 1 °C). The study was conducted on a negative control (C), a positive control with the addition of antioxidant (CB) butylated hydroxyanisole (E320), and two groups with the addition of NS oil at the level of 1.9% (O1) and 3.8% (O2). The quality parameters tested in the meat were colour (measured in the CIELab system), lipid oxidation products, the fatty acid profile, thrombogenicity (T1), atherogenicity (A1), and the ratio of hypocholesterolemia to hypercholesterolemia (h/H). After roasting the pâtés, their volatile compound profiles were studied and sensory tests were conducted. A significant effect of NS oil additive on meat colour was found and ΔE for C-O2 increased faster during storage than for C-O1 and C-CB. NS oil additive in pork pâté improved the fatty acid profile. Significant differences in the rate of the fatty acid profile change during storage were observed with the addition of 3.8% NS oil compared to the other groups. Only the O2 group showed no change in PUFA content, while the h/H ratio was approximately 20% higher in the groups with added oil. The addition of NS oil also slowed the growth of TBARSs compared to the C and CB groups. The volatile compound profile of the raw pâté was most influenced by the proportion of terpenes in the NS oil. After two months of meat storage, the O1 pâté received the highest sensory ratings.

This narrative review presents a comprehensive overview of the diagnosis and management of pityriasis versicolor (PV), a common superficial fungal infection caused by the yeast Malassezia. PV is characterised by scaly hypopigmented or hyperpigmented patches, primarily affecting the upper trunk, neck, and upper arms. Regarding commensal interactions, Malassezia utilises nutrient sources without affecting the human host. In cases of pathogenicity, Malassezia can directly harm the host via virulence factors or toxins, or indirectly by triggering damaging host responses. The diagnosis typically relies on recognising characteristic clinical features. Due to the wide variability in its clinical presentation, recognising the differential diagnosis is critical. In this paper, we discuss the clinical differentials, with their dermatoscopic presentation, but also describe a range of helpful diagnostic techniques (microscopy, conventional and ultraviolet-induced fluorescence dermatoscopy, and confocal microscopy). Topical therapies are the primary treatment for PV, encompassing non-specific antifungal agents like sulphur with salicylic acid, selenium sulphide 2.5%, and zinc pyrithione. Additionally, specific topical antifungal medications with either fungicidal or fungistatic properties may also be incorporated into the topical treatment regimen, such as imidazoles, allylamines, and ciclopirox olamine. Systemic therapies might occasionally be used. Patient education and the promotion of good personal hygiene are pivotal to reduce the risk of recurrence. In recurrent cases, particularly during warmer and more humid periods, prolonged prophylaxis with topical agents should be considered.

AIM: To assess the incidence of mitral valve prolapse in patients with newly diagnosed primary open angle glaucoma. METHODS: The study included 12 patients without any other comorbidities or taking any general or local medications. Each patient underwent a full ophthalmological examination with visual field assessment and optical computed tomography of the macula and optic nerve head. Carotid Doppler ultrasound was performed to exclude impaired blood flow in this region and transthoracic echocardiography with assessment of the function and morphology of the heart valves. RESULTS: In the study group, mitral valve prolapse was found in seven patients (58.3%), while mitral valve regurgitation in 11 patients (91.7%). One case of normal pressure glaucoma and four cases of juvenile glaucoma were diagnosed. There were also other risk factors for glaucoma: myopia (58.3%), migraine headaches (41.7%), a positive family history of glaucoma (16.7%). CONCLUSION: Mitral valve prolapse could be indicated as a new risk factor for glaucoma. It seems reasonable to conduct screening tests for glaucoma in patients with mitral valve prolapse in the course of echocardiography.

BackgroundDue to the COVID-19 pandemic, healthcare organizations had to face challenging circumstances and modify the usual modality of service provision, introducing telehealth services in their routine patient care to lessen the risk of direct human-to-human exposure. Patients expressed concerns about personal visits to healthcare units and the possibility of accessing telemedicine turned out to be an effective tool for the continuity of care. Due to the limited experience with telemedicine before the COVID-19 pandemic in Poland, we sought to fill this gap by studying the experiences of Polish patients. Our study aimed to understand how patients define satisfaction and dissatisfaction with telemedicine during the COVID-19 pandemic in primary care.Material and methodsTwenty semi-structured interviews with primary care patients in the Podlaskie Voivodeship, Poland were conducted to understand satisfaction with telemedicine. Interview transcripts were analyzed using qualitative content analysis. The qualitative content analysis process involved familiarizing ourselves with the data, extracting text regarding satisfaction and dissatisfaction with the teleconsultation, condensing it into meaningful units assigning codes to them, and organizing codes into subcategories and categories. The entire analysis process was done through reflection and discussion until a consensus was reached between the researchers.ResultsFrom the participants' perspective, satisfaction with telemedicine was associated with receiving enough space to express their concerns. It was reported that they trusted their primary care physicians and felt comfortable during telemedicine consultations. Participants noted that connecting with a known, trusted doctor was more important than having a face-to-face visit with an unfamiliar physician. In our study, the participants equated satisfaction with treatment effectiveness. It was emphasized that in the event of unknown or unstable conditions, patients would prefer to be seen in person and receive a physical examination.ConclusionIn our research telemedicine met with a positive reception and was recognized by the majority of patients who made use of it as a valuable channel of contact with a primary care physician. In order to increase the level of patient satisfaction, the focus should be on improving aspects such as physician engagement and showing empathy during telemedicine, as well as providing complete, exhaustive information on the treatment process. Respecting patient needs and preferences during performing telemedicine visits is the goal of patient-centered care.

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Abstract Research objective The COVID-19 pandemic disrupted healthcare delivery worldwide with likely negative effects on people who use opioids (PWUO). This scoping review of the original research literature describes the impact of the COVID-19 pandemic on healthcare delivery for PWUO and identifies gaps in the literature. Methods This scoping review of the original research literature maps the available knowledge regarding the impact of the COVID-19 pandemic on healthcare delivery for PWUO. We utilized the methodology developed by the Joanna Briggs Institute for scoping reviews, and content analyses methodology to characterize the current state of the literature. Results Of the 14 included studies, administrative database (n = 11), cross-sectional (n = 1) or qualitative (n = 2) studies demonstrated service gaps (n = 7), patient/provider experiences (n = 3), and patient outcomes for PWUO (n = 4). In March 2020, healthcare utilization dropped quickly, sharply increasing only for reasons of opioid overdose by May 2020. Service gaps existed in accessing treatment for new patients during the pandemic due to capacity and infrastructure limits. Physicians reported difficulty referring patients to begin an outpatient opioid treatment program due to increased restrictions in capacity and infrastructure. Patients also reported uncertainty about accessing outpatient treatment, but that telehealth initiation of buprenorphine increased access to treatment from home. Disproportionate increases in overdose rates among African Americans were reported in two studies, with differences by race and gender not examined in most studies. Fatal overdoses increased 60% in African Americans during the pandemic, while fatal overdoses in Non-Hispanic White individuals decreased. Conclusions In summary, this beginning evidence demonstrates that despite early reluctance to use the healthcare system, opioid overdose-related use of healthcare increased throughout the pandemic. Service delivery for medications to treat OUD remained at or above pre-pandemic levels, indicating the ability of telehealth to meet demand. Yet, racial disparities that existed pre-pandemic for PWUO are intensifying, and targeted intervention for high-risk groups is warranted to prevent further mortality. As the pandemic progresses, future research must focus on identifying and supporting subgroups of PWUO who are at heightened risk for experiencing negative outcomes and lack of access to care.