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Polyphenols are natural compounds found in many plants and their products. Their high structural diversity bestows upon them a range of anti-inflammatory, anti-oxidant, proapoptotic, anti-angiogenic, and anti-metastatic properties, and a growing body of research indicates that a polyphenol-rich diet can inhibit cancer development in humans. Polyphenolic compounds may modulate the expression, secretion, or activity of compounds that play a significant role in carcinogenesis, including type IV collagenases, such as matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9), by suppressing cellular signaling pathways such as nuclear factor-kappa B. These enzymes are responsible for the degradation of the extracellular matrix, thus promoting the progression of cancer. This review discusses the current state of knowledge concerning the anti-cancer activity of polyphenols, particularly curcumin, resveratrol, epigallocatechin-3-gallate, genistein, and quercetin, with a specific focus on their anti-invasive and anti-metastatic potential, based on the most recent in vitro and in vivo studies. It appears that polyphenols may be valuable options for the chemoprevention and treatment of cancer via the inhibition of MMP-2 and MMP-9 and the suppression of signaling pathways regulating their expression and activity.

Background: The dysregulation of extraocular muscles (EOMs) in the strabismus may be partly due to modification in the mitochondrial DNA (mtDNA). Currently, little is known about changes occurring in mtDNA of EOMs in patients with strabismus, therefore the aim of our study was to analyze if there are any changes occurring in the mitochondrial DNA of extraocular muscles in children that underwent strabismus surgery in our clinic. Methods: MtDNA was isolated from the tissue material using the Qiagen kit. Assessment of mtDNA mutations was performed by next-generation sequencing (NGS) using the Illumina MiSeq protocol. Results: The examination revealed the presence of atrophic changes in muscle fibers. NGS evaluation revealed a dominant genetic mutation in the ANT1 gene in 12 of the 15 patients examined. Conclusions: The presented results constitute the beginning of research on changes in mtDNA occurring in the muscles of children with strabismus surgery. Further studies are necessary in the context of resolving the transcriptomic differences between strabismic and non-strabismic EOMs. Better understanding of the molecular genetics of strabismus will lead to improved knowledge of the disease mechanisms and ultimately to a more effective treatment.

Introduction: Percutaneous endoscopic gastrostomy (PEG) has become the primary procedure for long-term enteral nutrition of most, but not all patients with dysphagia. Still in some patients gastrostomy may only be performed with open surgical technique (SG). Finally, in some patients due to relative contraindications to both methods, surgeons have to choose one of them., Aim: To compare PEG with SG in terms of effectiveness and safety., Material and Methods: A retrospective study of 612 patients with dysphagia, who underwent PEG (573) or SG (39) was conducted. Authors analysed effectiveness of PEG and SG procedures as well as the type, frequency and treatment methods of complications classified according to Clavien-Dindo Classification., Results: The rate of all complications was significantly lower for PEG than for SG and a significant effect of the treatment type on the probability of serious complications was observed - notably lower after PEG (OR = 0.21, 95% CI: 0.05-0.8, p = 0.02). The 30-day mortality rate was 1.74% for PEG and 0% for SG. PEG patients who required laparotomy were over 30 times more likely to die than others. No significant effect of the nutrition status on the probability of serious complications was observed (OR = 0.83, 95% CI: 0.51-1.34, p = 0.46)., Conclusions: A significant effect of the treatment type on the probability of serious complications was confirmed. This result was robust to the preoperative patients' nutrition status which was found to be insignificant. A lower risk of postoperative complications, a relatively easy procedure make PEG a procedure of choice in patients with dysphagia., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2022 Fundacja Videochirurgii.)

This presented work investigate the bio-convections effects of the magnetized time dependent axisymmetric flow of Carreau-nanomaterial performances with multiple slip effects over a stretching sheet. The momentum, heat, concentration and density of motile micro-organism are renovated into the system of equation via using well known similarity revolution. Well known Mathematical computational techniques and software (i.e. bvp4c and MATLAB) are used to draw graphical and tabular results. Velocity profile equation [Formula: see text], energy equation [Formula: see text], volumetric nanoparticles [Formula: see text], density motile microorganism [Formula: see text].The Carreau viscosity model is use to reduce the viscosity of fluid when [Formula: see text] and [Formula: see text]. Besides we moderate this into power law index with [Formula: see text] and [Formula: see text] partial slip condition of velocity is also instigated at the surface. Gravity dependent gyrotactic nanoparticles are utilized for well observing axisymmetric flow with convective boundary layer condition and comparatively better heat transfer rate result and applicable to maximum realistic approach., (© 2022. The Author(s).)

The reliability of the usage of a splitter plate (passive control device) downstream of the obstacle, in suppressing the fluid forces on a circular obstacle of diameter [Formula: see text] is studied in this paper. The first parameter of the current study is the attachment of a splitter plate of various lengths [Formula: see text] with the obstacle, whereas the gap separation [Formula: see text] between the splitter plate and the obstacle, is used as a second parameter. The control elements of the first and second parameters are varied from [Formula: see text] to [Formula: see text]. For the attached splitter plates of lengths [Formula: see text] and [Formula: see text], the oscillatory behavior of transient flow at [Formula: see text] is successfully controlled. For the gap separation, [Formula: see text] and [Formula: see text] similar results are obtained. However, it is observed that a splitter plate of too short length and a plate located at the inappropriate gap from the obstacle, are worthless. A computational strategy based on the finite element method is utilized due to the complicated representative equations. For a clear physical depiction of the problem, velocity and pressure plots have been provided. Drag and lift coefficients the hydrodynamic benchmark values are also evaluated in a graphical representation surrounding the obstacle's peripheral surface as well as the splitter plate. In a conclusion, a splitter plate can function to control fluid forces whether it is attached or detached, based on plate length and gap separation between obstacle and plate, respectively., (© 2022. The Author(s).)

The communication describes a theoretical framework for tangent hyperbolic fluid of nano-biofilm due to an extending or shrinking sheet that comprises a stagnation point flow, chemical reaction with activation energy, and bioconvection of gyrotactic microorganisms. The varying transport features due to dynamic viscosity, thermal conductivity, nano-particle mass permeability and microbe organisms diffusivity are taken into account for the novelty of this work. The inspiration is developed to enhance heat transfer. A set of leading partial differential equations is formed along with appropriate boundary constraints. Using similarity transformations, the basic formulation is transitioned into non-linear differential equations. To produce observational data, the shooting technique and Runge-Kutta fourth order method are employed. The coding of numerical scheme is developed in Matlab script. The visual representation of the effects of diverse fluid transport properties and distinctive parameters on speed, temperature, concentration and motile density are evaluated. The velocity become faster when the parameters [Formula: see text], [Formula: see text], [Formula: see text] and [Formula: see text] are enhanced. Brownian motion, thermal conductivity, heat generation as well as thermophoresis factors all strengthen the temperature distribution, however the nano-particle concentration profile is enhanced as the nano-particle mass conductivity variable, activation energy as well as the thermophoresis variable are boosted. The microorganism density improves significantly when the microorganism diffusivity factor increases. The skin friction, Sherwood number, Nusselt number and motile density number decline against the incremented transport parameters., (© 2022. The Author(s).)

The unsteady energy and mass transport of magnetohydrodynamics (MHD) second grade nanofluid via an exponentially extending surface with Dufour and Soret effects are investigated in this study. Variable thermal conductivity and mixed convection effects are used to investigate the heat transfer mechanism. There are also new characteristics such as slip flow, viscous dissipation, Brownian motion, nonlinear thermal radiation, and thermophoresis. In the problem formulation, the boundary-layer approximation is used. Using the suitable transformations, the energy, momentum, and concentration equations are generated into non-linear ordinary differential equations (ODEs). The solution to the resultant problems was calculated via the Homotopy analysis method (HAM). The effects of environmental parameters on velocity, temperature, and concentration profiles are graphically depicted. When comparing the current results to the previous literature, there was also a satisfactory level of agreement. In comparison to a flow based on constant characteristics, the flow with variable thermal conductivity is shown to be significantly different and realistic. The temperature of the fluid grew in direct proportion to the thermophoresis motion, buoyancy ratio, and Brownian motion parameters. According to the findings, the slippery porous surface may be employed efficiently in chemical and mechanical sectors that deal with a variety of very viscous flows., (© 2022. The Author(s).)

Objectives: Biological weapons are one of the oldest weapons of mass destruction used by man. Their use has not only determined the outcome of battles, but also influenced the fate of entire civilizations. Although the use of biological weapons agents in a terrorist attack is currently unlikely, all services responsible for the surveillance and removal of epidemiological threats must have clear guidelines and emergency response plans., Methods: In the face of the numerous threats appearing in the world, it has become necessary to put the main emphasis on modernizing, securing, and maintaining structures in the field of medicine which are prepared for unforeseen crises and situations related to the use of biological agents., Results: This article presents Poland's current preparation to take action in the event of a bioterrorist threat. The study presents both the military aspect and procedures for dealing with contamination., Conclusions: In Poland, as in other European Union countries fighting terrorism, preparations should be made to defend against biological attacks, improve the flow of information on the European security system, strengthen research centers, train staff, create observation units and vaccination centers, as well as prepare hospitals for the hospitalization of patients-potential victims of bioterrorist attacks.

Technical and technological progress in the 21st century, especially emerging geographic information system (GIS) technology, offers new and unprecedented opportunities to counteract the impact of crisis situations and emergencies. Computerization and development of GIS enabled the digital visualization of space for interactive analysis of multiple data in the form of models or simulations. Additionally, computerization, which gives rise to a new quality of database management, requires continuous modernization of computer hardware and software. This study examines selected examples of the implications and impact of the GIS commonly used in Poland.

The aim of the study was to investigate the influence of sand bed moisture on TNT transport from under the sand layer. The MO-2M explosive vapor detector was used, the detection mechanism of which is based on the FAIMS method. In addition, it was determined after what time the detector alarm appears, signaling the presence of TNT vapors, and how it affects the thickness of the sand layer. The performed work allowed us to assess the suitability and possibly adapt the MO-2M detector to detect non-metal mines, which will help develop new application possibilities for this device. These tests can also be used to eliminate environmental contamination resulting from the deposition of explosives in the ground and the migration of harmful compounds to groundwater.

According to the World Health Organization (WHO), ethyl alcohol occupies the third place among health risks for the general population, causing damage to health as well as social damage. Ethanol is also considered the greatest risk factor in injuries. Both alcohol and its main metabolite, acetaldehyde, are directly toxic to tissues and lead to several systemic pathologies. Alcohol abuse may also lead to mental health disorders. Although one-in-eight adult Poles abstains from drinking alkohol, 10-20% of adult Poles drink alcohol regularly. It is estimated that this group includes about 900,000 addicts, and over 2,000,000 people who drink alcohol at a risky or harmful level. It affects their occurrence and their consequences Drink- driving is one of the problems most often raised, although alcohol is a documented risk factor in pedestrian accidents. It is also an important risk factor for suicidal behaviour with people under the influence of alcohol choosing more radical and effective methods of committing suicide, such as hanging or 'throwing themselves under a moving vehicle.' Only properly selected and consistently taken preventive actions can improve the tragic statistics related to ethanol stimulating risky and auto-aggressive behaviours. It is also necessary to improve the system for reporting such events because only reliable statistics enable proper assessment of the scale of the problem, and the effectiveness of these activities.

According to the World Health Organization (WHO), more than half of all road fatalities involve vulnerable road users, i.e., pedestrians, cyclists, and motorcyclists. Poland is classified as one of the European Union (EU) countries marked by low road safety, with a higher frequency of accidents involving pedestrians compared to other EU countries (31% of all fatalities). Among unprotected road users, a significant group of victims are pedestrians, who are often under the influence of alcohol. This study aims to analyze the impact of alcohol on the risk of occurrence and consequences of road accidents among pedestrians. The source of data was the medical documentation of the Department of Forensic Medicine of the Medical University of Warsaw. In more than half of pedestrian deaths, the presence of alcohol was found; regardless of the place of the event and the place of death, among the victims under the influence of alcohol, males dominated; the average age of the victims under the influence of alcohol was significantly lower compared to the average age of sober victims, with younger victims being significantly more likely to die at the scene of the accident, especially in rural areas; significantly higher alcohol concentrations were found in males, in victims who died at the scene of the accident, and with victims of accidents in rural areas. Among pedestrian traffic accident fatalities, the most numerous group comprised young men under the influence of alcohol. In rural areas, a higher percentage of pedestrian victims died at the scene as a result of excessive alcohol consumption. These areas should be subject to intensive preventive measures to increase the safety of pedestrians as unprotected road users.

Suicide is one of the ten most common causes of death in the world. Of all deaths from suicide, 22% can be attributed to the use of alcohol, which means that every fifth suicide would not occur if alcohol were not consumed by the population. People under the influence of alcohol choose more radical and effective methods of dying by suicide, e.g., throwing themselves under a moving vehicle, such as a train. The presented analysis aimed to determine important risk factors affecting railway suicide in Poland and their relation to the state of alcohol intoxication of the victims, and the relationship between ethyl alcohol consumption and the phenomenon of suicide. Documentation obtained from the Department of Forensic Medicine at the Medical University of Warsaw, in the form of death registers and forensic medical records concerning examination and autopsy, was analyzed. This made it possible to identify suicide victims from among pedestrian victims of railway accidents recorded during the period under study. The research was carried out using unidimensional and multidimensional statistical analyses with IBM SPSS Statistics, version 25. Sober suicide victims were statistically significantly older than victims under the influence of alcohol; alcohol concentration was correlated with the age of the victims-the older the victims were, the higher the alcohol concentration. A significantly higher number of deaths attributed to suicide by sober victims was observed in autumn compared to other seasons. Multidimensional analysis showed a statistically significant effect of age and season on the probability of dying by suicide under the influence of alcohol-this probability decreases with the age of the victims and is also significantly lower in autumn. The observed relationship between age and the presence of alcohol in suicide victims can be the cause of railway suicides. Knowledge of the mechanisms of seasonal variability of suicidal behavior can help to develop effective strategies to prevent railway suicides. It is necessary to improve the system of reporting railway suicides, as only reliable statistics provide the possibility of assessing both the scale of the problem and the effectiveness of actions taken.

Aims: An integral part of the World Health Organization (WHO) plan to reduce suicide by 10% by 2020 is to identify areas and demographic groups, which should be priority target groups for preventive activities. This study aimed to present the demographic differences between victims of suicide by hanging in the Warsaw metropolitan area, in Poland, by examining the sobriety of victims., Methods: Data for analysis were obtained from the documentation of the Department of Forensic Medicine (DFM) at the Medical University of Warsaw (MUW). The retrospective analysis included 358 out of 466 victims of suicides by hanging in the Warsaw metropolitan area, in Poland, recorded in the DFM documentation covering 2011-2013. The data gathered included age, gender, the cause of death, a post-mortem examination as well as the level of ethanol in the blood and muscles of victims., Results: In both groups, men accounted for a larger percentage of victims than women, P = 0.068. In the no-alcohol group, the victims were older than in the alcohol group (47.52 ± 19.21 vs. 40.88 ± 12.77) (P < 0.001). The majority of the studied population were victims aged 25-34 (22.90%), mainly men (20.95%). Young men were also the largest group among victims in the alcohol group (28.33%). The most numerous age group among no-alcohol group were older victims aged 55-64 (19.10%), especially men (16.29%)., Conclusion: Regardless of sobriety, men were the largest group of suicide victims in the study population, which means that men die suicide more often than women. Differences in gender proportions are related to age. In the studied population, it was primarily young victims, mainly men. These are the groups that should be priority target groups for preventive activities aimed at reducing the number of suicides. The presence of ethanol in more than half of the victims of suicide in the study population indicates that alcohol is an important suicidal risk factor., (© The Author(s) 2020. Medical Council on Alcohol and Oxford University Press. All rights reserved.)

Medical facilities, while providing both essential and demanding health care to society's most vulnerable populations, also belong to the most demanding category of risk to human life if and when a crisis event occurs within its walls. The development of a safe evacuation plan for these facilities is extremely complicated, as the evacuation of medical facilities is much more complex than for other critical infrastructure. In this category, the evacuated patients constitute a specific risk group requiring specialized medical care. Hospitalized persons may be dependent on life-saving measures, are unconscious or immobile, are significantly restricted in movement or mentally unbalanced, being dependent on the continued assistance of trained third parties. Additionally, the medical transport of evacuated patients becomes more difficult due to the limited capacity of ambulances and available health care facilities to transport them to, which are increasingly limited due to their overcrowded census. The study aimed to analyze the requirements which are placed on hospitals in Poland to ensure the safety of patients in case of an evacuation. The research method used in the paper was retrospective analysis and evaluation of the media and literature. We have found, that Polish law imposes an obligation on the administrator of a medical facility to ensure the safety of both patients and employees. The regulations cover issues of technical conditions to be met by buildings and their location, prevention, and fire protection requirements, and the determination of which staff is responsible for the evacuation. However, available documents fail to describe what the hospital evacuation process itself should entail under emergency evacuation. Taking into account the complexity of the hospital evacuation process, health care facilities should have a well-developed plan of action that must be implemented at least once a year in the form of facility-wide training. Evacuation drills should not be avoided. Only trained procedures offer the possibility of later analysis to identify and eliminate errors and provide the opportunity to acquire skill sets and habits which promote the behaviors expected in real-life emergencies.

Introduction: The article presents the epidemiology of road traffic injuries and fatalities in Poland in the years 2004-2014. In Poland, every fourth death caused by external reasons is the result of a road traffic crash and Poland has one of the highest road fatality rates in relation to vehicle ownership in Europe, with an average 23 deaths per million residents. This rate is two times higher than most other European Union countries., Materials and Methods: The research is based on a secondary analysis of data contained in multiple Polish governmental reports, including those of the Prevention and Analysis Office of Road Traffic Headquarters of Police, National Road Safety Program-GAMBIT 2005, National Road Safety Program 2013 to 2020, and Strategy for Efficient State in 2020, plus previous publications describing road safety in Poland. Data were analysed in two steps. First, the data were described using means and frequencies, and tabulated according to variables. Second, we considered the time frame (day, month, and year of the occurrence), the place and the circumstances of fatal road crashes, the kind of event, and types of road crashes., Results: Between 2004 and 2014, there were 475,591 traffic crashes on Polish roads. 52,217 people were killed and 597,191 people were injured. Traffic-related injuries represent the leading cause of death for Polish men up to 44 years of age. The most common cause of road crashes in Poland was failure to comply with the rules of the road traffic, such as through excessive speeding. We also found drivers poorly assessed road situations, faced a lack of adequate road infrastructure, and maintained many vehicles in poor condition., Discussion: Despite the variety of measures undertaken to improve safety on Polish roads, including modifications of the law as well as improving road quality, the number of fatalities and injuries resulting from motor vehicle crashes is still considerable, and the losses incurred by Polish society are still substantial., Conclusions: The number of fatalities and injuries as a result of road crashes in Poland remains very high. Multifaceted action to improve safety on the roads in Poland should continue.

Introduction: Suicide is one of the most frequent causes of death. According to the World Health Organization (WHO), each year, over eight hundred thousand people worldwide die as a result of suicide. The most common risk factors for suicide are depressive disorders and alcohol dependence. Alcohol can directly influence a decision about suicide, or be a factor facilitating this decision. The aim of the study was to analyse the seasonality of suicides among persons under the influence of alcohol., Material and Methods: Data for analysis were obtained from the Department of Forensic Medicine (DFM) of the Medical University of Warsaw. A retrospective analysis was performed on 317 victims of suicides by hanging, those which were entered into the registry of deaths kept by the DFM in the years 2009-2013. The analysis took into account the age and sex of victims, initial cause of death, date of post-mortem examination, autopsy result and alcohol concentration in the blood or muscles of the victims. Statistical analysis was performed using IBM SPSS Statistics version 20., Results: In the analysis, a spring peak of suicides was found for men, and an autumn peak was revealed for women. In addition, a significant correlation was observed between the age of victims and the concentration of alcohol; the older the victims, the higher the alcohol concentration. However, this correlation was reported only in the spring months., Conclusions: The results of the analysis seem to be consistent with seasonal patterns observed in other studies, and they indicate the occurrence of suicide seasonality. In order to improve the strategies of suicide prevention, it is necessary to identify factors which are related to the seasonal variation of suicidal behaviours, as well as to gain knowledge about the mechanisms behind this phenomenon.

Introduction: Every year more than 1.2 million people worldwide die due to trauma sustained in road crashes, with an additional number of people injured exceeding 50 million. To a large extent, this applies to so called "unprotected road users", including pedestrians. The risk involved in a traffic crash for pedestrians can result from many factors, one of which is participation in road traffic when under the influence of alcohol. The aim of this study was to analyze the impact of alcohol use among pedestrians as unprotected road traffic participants, and the consequences of them being struck by motor vehicles., Material and Methods: The source of data was the medical documentation of the Department of Forensic Medicine at the Medical University of Warsaw. The sample for this research consisted of 313 pedestrians who were victims of fatal road crashes resulting from a collision with a mechanical vehicle. The obtained results were subjected to statistical analysis using the STATISTICA version 12.5 program (StatSoft Polska, Cracow, Poland)., Results: Male fatalities constituted the majority of the study sample. Nearly half of the fatal pedestrian victims were found to be under the influence of alcohol. The statistical analysis demonstrated a significant relationship between the gender and age of the victims, as well as between the place of the event, the place of death, the mechanism of the event, and the presence of alcohol in pedestrians., Conclusions: Among pedestrians, victims of road crashes who were under the influence of alcohol were predominantly drunk young males. Victims under the influence of alcohol were more likely to become fatalities in crashes where the mechanism of the incident was being struck by a passenger car, and when the place of the incident was a rural area, in these cases the rates of death directly at the scene were much more frequent. The eradication of alcohol consumption by all road users should be the overriding objective of all measures aimed at reducing the number of road crashes.

Objective: The aim of the research was to assess the prevalence, effects and risk factors for motor vehicle accidents (MVA) in the years 2004-2017 in Poland., Method: We merged secondary data from the Prevention and Analysis Office of Road Traffic Headquarters of Police and Central Statistical Office of Poland., Results: Our results suggest that several thousand people are killed on Polish roads annually, and tens of thousands are injured. Road crashes represent the leading cause of death for Polish men up to 44 years of age. The most common causes of road crashes in Poland include failure to comply with the road traffic rules and low driving skills. We also found drivers who poorly assessed road situations, roads characterized by a lack of adequate road infrastructure, and many vehicles in poor condition. Road crashes have become a significant public health and social problem globally. Drivers caused most MVA in Poland in the years 2004-2017, whereas the underlying cause was inadequate speed regarding the road traffic condition as well as not respecting the right-of-way. Despite various measures that are being taken to improve safety on Polish roads, the number of the dead and wounded as a result of road accidents is still high and the losses to the society are considerable as well., Conclusion: It is necessary to continue multidirectional actions to improve safety on the roads in Poland resulting in a systematic increase in the level of road traffic security.

Background: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the digestive system. The primary location of GISTs is mainly the gastrointestinal system. Clinical symptoms are nonspecific and mainly depend on the location and size of the tumor., Objectives: The aim of this study was to conduct a clinical and pathological analysis of 18 cases of GISTs from the medical records of the Department of Surgery at the 4th Military Teaching Hospital in Wrocław, Poland., Material and Methods: The medical records were of women and men at the age of 36-84 years who were treated in the Surgical Clinic. The medical data that was gathered included clinical records, histopathological results and the type of surgical treatment. The study also encompassed the anatomical location and size of the tumor as well as microscopic examination of the tumor., Results: In most cases, GISTs were located in the stomach. The most common symptoms were stomachaches and signs of bleeding into the digestive system. Usually, the tumor presented a diameter of <5 cm and a low grade of malignancy. Out of 18 patients, 16 were treated with laparoscopic resection, whereas in the remaining 2 cases, multiorgan resections were carried out, because the tumor was locally advanced., Conclusions: It is essential to distinguish stromal tumors from other mesenchymal tumors, since GISTs are among the cancers that have a high risk of malignant progression. The conditions for successful treatment are a properly established histopathological diagnosis, accompanied by immunohistochemical tests for CD117, and a combination of antibodies for a differential diagnosis of other mesenchymal tumors.

Objective: Introduction: The ability to provide first aid, especially cardiopulmonary resuscitation (CPR) in accordance with the guidelines of the European Resuscitation Council (ERC) is a key element in helping and rescuing people with pre-hospital cardiac arrest. As recommended by the ERC 2015 guidelines, one of the most important steps to be taken to increase the rate of CPR appraisal by participants or cardiac arrest witnesses is to teach these skills to all children in schools. Numerous studies have shown that school-age children are positive about learning resuscitation, and moreover, they are important multipliers of knowledge because they are happy to transmit the information they receive to family members and the closest surroundings. The aim: To get to know the opinions of young people about the need for first aid education and the period in which it is best to start learning in this area., Patients and Methods: Materials and methods: The study was attended by 498 people, students of various types of universities, the research method was an online diagnostic survey, a self-help questionnaire tool., Results: Results: The study involved 309 women (62%) and 189 (38%) men. The respondents are young people between 18-30. Almost all respondents (97.2%) are of the opinion that learning first aid should be compulsory in the course of school education. The majority of respondents (76.7%) expressed the opinion that the knowledge regarding first aid should be updated, 16.3% had no opinion on this subject, while only 7.0% of respondents believed that there was no need to do so. Almost half of respondents (48.3%) are of the opinion that learning first aid should take place from the elementary school, while 30.3% of respondents think that they should be educated at pre-school age., Conclusion: Conclusions: The vast majority of respondents consider first aid education to be significant and needed during education. Young people are aware of the need to practice skills and to repeat and update information on first aid. The majority of respondents are of the opinion that education in this area should be started very early, even in the pre-school period.

The philosophy underlying the procedure with the trace from the moment of the securing of the evidence up to its ultimate inspection is of significance for the result achieved. Hands of the people who conduct investigative action or of the experts involved in examinations contaminated with explosives may adversely affect results of the analyses. The contamination effect is one of the most dangerous consequences of non-observance of the strict rules in handling the traces secured on the crime scene. The aim of this research work was to examine whether at all, and if so, with what an ease and at which stage of the analytical procedure there occurs a likely contamination of the evidence material with explosives such as TNT, RDX, PETN, NG. The analytical procedure employed consisted of the sampling stage, extraction from gauze swab, transfer of the extract and execution of an instrumental analysis based on gas chromatography with electron capture detector (ECD). The most significant contamination effect was observed during the analytical procedure for TNT, followed by a similar, yet less pronounced, for RDX and PETN. Contaminating the research material with nitroglycerin, known to be liquid under normal conditions, proved unsuccessful., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Introduction and Objective: Firefighters are considered a healthy and fit group of individuals, well-prepared for taking action in disaster situations. While working, they suffer from exposure to certain toxic agents, especially combustion products generated when a fire takes place. Among them, the most frequent and the most toxic are: carbon monoxide, hydrogen cyanide, ammonia, and those resulting from PVC combustion - hydrochloride, phosgene and chloride. Additionally, fire-extinguisher powder can be inhaled and lead to certain lesion in the airways. The aim of study was to ascertain the influence of toxic agents present at the scene of fire on the lung tissue of firefighters, and also to study this on an animal model., Material and Methods: The study group consisted of firefighters who had a minimum of 10 years service. After completing a questionnaire, their clinical status was ascertained based on a general examination, laboratory tests and lung function tests., Results: Questionnaire analysis showed a high percentage of pathological symptoms in the studied group. The incidence of the symptoms correlated with the duration of occupational exposure to toxic agents. Among other results, obstruction of flow in medium airways in about 30% of the studied individuals represented the most important finding. Experimental tests were next performed on male Wistar rats, aged 3 months. They were insufflated with the solution of powdered fire-extinguisher, after which morphology specimens of lung tissue were studied. Evidence for disseminated fibrosis was obtained, which supported the previous clinical findings in the firefighters., Conclusions: The above shows correlation between occupational exposure and respiratory system involvement in firefighters. This justifies covering the group of firefighters with special medical care focused on prophilaxis, early detection and therapy of pulmonary diseases.

The current practice in securing the contact traces of chemical substances taken from clothes belonging to a person suspected of manual handling explosives is focused on pockets and cuffs. The outerwear worn by people who had contact with fluorescent powders that simulate explosives and drugs was the subject of this study. Clothes were first exposed to the test substance for a period of time and then analyzed by fluorescence methods to determine the location of the highest quantity of traces. The results obtained from the study confirm that the areas with the highest concentration of powdery traces are different from those suggested by current forensic practice. They appear to be promising for a more efficient identification of the suspects involved in illegal manufacturing of drugs of abuse or explosives. Moreover, they may be helpful for developing the methodology for handling the evidence material in the forensic clothing examination process., (© 2016 American Academy of Forensic Sciences.)

Road accidents are a serious problem of the modern world. They are one of the main causes of injuries and are the third most frequent cause of death. Every year, about one million people, adults and children, die on the roads and several millions get injured. Mortality rate due to injuries from road accidents amounts to 2.2% of all deaths in the world. The research presents epidemiology of road accidents in the period 2004-2015 with particular emphasis on the key issues of road safety in Poland, related to the dangerous behaviour of road users (disregard toward traffic rules). Between years 2004 and 2015 on Polish roads took place more than 508000 accidents with 53155 fatalities and more then 572000 casualties. Despite the various measures which are taken to improve safety on Polish roads, the number of dead and wounded in the vehicle mishap is still large, and losses borne by society are high. To improve safety on Polish roads, it is necessary to continue multi- action plan to systematically progress in the level of road safety.

Background: Burnout is a syndrome of emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment. Symptoms of burnout include mental and physical exhaustion, accompanied by psychosomatic disorders and emotional problems. Burnout occurs most often in people employed in occupations requiring working with people (human services) as a result of coping with stress and experience numerous failures at work. The aim of the research is the analysis of burnout among physiotherapists and demographic factors and conditions that may contribute to the burnout., Material and Methods: 212 (137 woman and 75 man) physiotherapists completed an anonymous questionnaire to assess burnout created by Owczarek and Olczyk. The age of respondents ranged between 20 to 56 years, with work experience from several months to more than 30 years., Results: Total score of burnout was 115,66 (SD 21,78). On the scale of attitude to work 36,82 was achieved, workload - 34,76, contact with the patient - 27,54, and an attitude towards stress - 16,54, which means that the result obtained fit in the lower zone including average results concerning the level of burnout. Women had a higher level of professional burnout than men. Respondents who reported that their working conditions are not conducive to achieving therapeutic success (quality of equipment, size of treatment rooms, treatment technologies), exhibited a higher level of burnout. The average result of the level of burnout among physiotherapists is lower than all the results obtained in other occupational groups of health care workers, lead with the same diagnostic tool., Conclusions: Burnout syndrome among practicing physiotherapists require further study, taking into account the type and quality of jobs, but also the level of referral among professional physiotherapists.

Introduction: Cancer of the gallbladder is a serious diagnostic and therapeutic problem. According to the literature, 30% of cases are not confirmed before surgery. Other cases are detected incidentally by histopathology. Clinical trials and meta-analyses show that incidental gallbladder cancer (iGBC) occurs in 0.19%-2.8% of patients after cholecystectomy. The aim of this study was to analyze the incidence and severity of iGBC in cholecystectomy procedures performed in the surgical department at the 4th Military Teaching Hospital in Wroclaw during the years 1990-2014., Patients and Methods: In the years 1990-2014, a total of 7,314 cholecystectomies were performed in the surgical department because of cholecystolithiasis: 6,145 were performed using the laparoscopic approach (84.02%), 867 were performed as open surgery (11.8%), and 302 cases required conversion (5.1%). In this group, 5,214 of the patients were females (71.3%) and 2,100 were males (28.7%), with an average age of 54.7 years., Results: We found 64 iGBC cases which were confirmed by histopathology. This represented 0.87% of all cases. In this group, 50 patients were females (78.1%) and 14 were males (21.8%), with an average age of 67.1 years. Of this group, 40 patients underwent a classic cholecystectomy, while 24 underwent laparoscopic procedures, out of which 13 cases ultimately required traditional surgery. The histopathology showed 15 carcinomas that were classified as G1 (23.4%), 28 were G2 (43.75%), and 21 were G3 (32.8%)., Conclusion: iGBC detected after a cholecystectomy due to cholecystolithiasis is a rare disease. We found iGBC in 0.87% of cases, which is on a comparable scale to the world literature. In the case of cancer, we frequently found it necessary to convert to an open surgical procedure. This cancer is more common in females and in people over 60 years of age.

Introduction: Nowadays, the problem of road accident rates is one of the most important health and social policy issues concerning the countries in all continents. Each year, nearly 1.3 million people worldwide lose their life on roads, and 20-50 million sustain severe injuries, the majority of which require long-term treatment., Discussion: The objective of the study was to identify the most frequent, constantly occurring causes of road accidents, as well as outline actions constituting a basis for the strategies and programmes aiming at improving traffic safety on local and global levels. Comparative analysis of literature concerning road safety was performed, confirming that although road accidents had a varied and frequently complex background, their causes have changed only to a small degree over the years. The causes include: lack of control and enforcement concerning implementation of traffic regulation (primarily driving at excessive speed, driving under the influence of alcohol, and not respecting the rights of other road users (mainly pedestrians and cyclists), lack of appropriate infrastructure and unroadworthy vehicles., Conclusions: The number of fatal accidents and severe injuries, resulting from road accidents, may be reduced through applying an integrated approach to safety on roads. The strategies and programmes for improving road traffic should include the following measures: reducing the risk of exposure to an accident, prevention of accidents, reduction in bodily injuries sustained in accidents, and reduction of the effects of injuries by improvement of post-accident medical care.

Unlabelled: At present, sentinel lymph node biopsy is a standard procedure to assess the advancement of breast cancer and cutaneous melanoma. The aim of the study was to assess the role of the sentinel lymph node biopsy in the treatment of patients with breast cancer in our own material., Material and Methods: Analyzed was medical documentation of 258 patients with initially operable breast cancer, qualified for operation with sentinel lymph node biopsy in 2004-2014 in the Department of Surgery of the 4th Military Teaching Hospital. A few hours prior to the planned surgery, radioisotope (technitium-99 sulfur colloid) was applied in the area of tumor or under the areola. 1-2 hours after administering the tracer, the lymphoscintigraphy with the labelling of the sentinel lymph node on the skin was performed., Results: On the basis of the gathered material, obtained were the following parameters: sensitivity - 100%, and specificity - 94.6%. Four cases were false negative (5.5%)., Conclusions: 1. Marking the sentinel lymph node in breast cancer, based on the single visualisation method with the use of radioisotope, is a useful and effective technique. 2. The factor influencing the results of the sentinel lymph node biopsy (true positive and negative results and false negative result) was the number of the excised lymph nodes except for the sentinel lymph node. 3. Patients with estrogen receptor expression had often metastases to sentinel lymph node (145 cases - 56%). 4. The false negative rate, i.e. 5.5% in our material, is within the limits of acceptability given in the literature. 5. The sentinel lymph node biopsy performed by the experienced surgical team is a reliable diagnostic tool with a low complication rate.

International humanitarian law provides special protection devices and medical personnel during armed conflicts. In today's wars it became more frequent lack of respect for the protective emblems of the red cross and red crescent and the lack of respect for medical activities. The paper presents selected issues of humanitarian law with a particular emphasis on the rules concerning the protection of medical services and victims of armed conflicts. All countries that have ratified the Geneva Conventions and Additional Protocols, are required to comply in time of war the principles contained in them and their dissemination in peacetime. Education societies in the field of international humanitarian law can help to eliminate attacks on medical facilities and personnel and significantly improve the fate of the victims of armed conflict and mitigate the cruelty of war. Knowledge of humanitarian law does not prevent further wars, but it can cause all parties to any armed conflict will abide by its rules during such activities.

Introduction: World-wide distributed pests of Plodia interpunctella occur with increasing frequency also in Poland, in areas where food is prepared and stored, in dwellings, buildings of public use, hospitals. Larvae damage various products causing economic losses. There were no data about microbiota transmission by pests. The aim of our systematic studies firstly conducted in Poland was to explain a role of pests as reservoirs of microbiota and assess health risk induced by them in human environments., Material and Methods: 300 adults and 200 larvae, collected in households and health facilities by traps and directly from products, were examined by light microscopy, in vitro cultivations, molecular techniques; the susceptibility /resistance of microbiota to chemicals was also assessed., Results: Gram+ bacteriae of genera Enterococcus, Micrococcus, Bacillus, Gram-: Klebsiella, Escherichia, mold fungi: Aspergillus, Penicillium and yeast-like fungi were identified, including strains potentially pathogenic for humans., Conclusions: In the European Union countries, the food circulation is audited by the law; chemicals are applied to eliminate P.interpunctella pests causing economic losses. Our successive studies showed that pyralids may generate health problems as food pests and as reservoirs of microbiota. Sources of the pathogenic, drug-resistant strains revealed by us, not identified earlier, may be particularly dangerous for elder persons, with weakened immune system, persons from groups of high risk of infections. The increased awareness of the problem is necessary for more efficacy of preventive measures. A monitoring of consequences of the health risk induced by the pests may supply data useful for adequate practical approach.

Hodgkin Lymphoma (HL) is a neoplastic disease of the lymphatic system, primary involving lymph nodes and extranodular organs. Despite successful combined chemotherapy, a proper and prompt diagnosis remains a difficult challenge. The case report documents the case of a 52-year-old patient, who had been diagnosed in various internal medicine wards for nonspecific diseases during last two years. Due to the worsening of patient's general condition and suspected inflammatory, probably purulent, abdominal process, he was operated twice. Unexplained symptoms of the uncertain origin resulted in the further lack of successful diagnosis and therapy. The patient died from multiple organ failure on the 2nd day after the second operation. The final histopathological and immunohistochemical examination of the liver biopsy revealed the primary cause of death, i.e. Hodgkin lymphoma. The thorough analysis of the patient's documentation revealed a full-featured image of the classic HL. A special emphasis was placed upon misleading symptoms and difficulties in correct interpretation of more sophisticated diagnostic methods. The significant features of these patients can provide sufficient guidance to proper diagnosis and treatment of this rare disease., (© 2015 MEDPRESS.)

The study presented a case of a gastrocutaneous fistula, as a result of bariatric sleeve gastrectomy. The discussion considered the main pathogenesis, etiology, diagnostics and endoscopic treatment using the implantation of covered esophageal stents. Special attention was placed upon the multifactorial origin of this life-threatening clinical condition, typical for bariatric surgery.

Background: Asymptomatic pancreatic necrosis should be managed conservatively, regardless of its extent. However, late sequelae and safety of non-interventional management in patients with asymptomatic walled-off necrosis remain unclear., Aims: The purpose of this study was to report the clinical outcome of outpatient expectant management in a cohort of patients with walled-off necrosis who were discharged asymptomatic after an episode of acute pancreatitis., Methods: Sixteen patients with walled-off necrosis asymptomatic at discharge were identified retrospectively from a single institution. Data were analyzed for the type of complications, their incidence and treatment., Results: Seven of 16 patients (44 %) did not experience any complications during a median follow-up of 17 months. Nine of 16 patients (56 %) became symptomatic or developed complications within a median follow-up of 49 days after discharge. The most common complication was infection of pancreatic necrosis which occurred in 7 of 9 patients. Six of these patients were successfully treated with minimally invasive techniques. In 5 of 7 patients, infection of necrosis was due to oral commensal bacteria. Acute intracavitary hemorrhage and intractable abdominal pain developed in one patient each. There was no mortality in this series., Conclusions: Outpatient watchful waiting can be used safely in patients with asymptomatic walled-off necrosis, although nearly half of them eventually develop complications which require interventional treatment. Most late infections of pancreatic necrosis are probably due to a blood-borne transmission of oral commensal bacteria.

Amphizoic amoebae generate a serious human health threat due to their pathogenic potential as facultative parasites, causative agents of vision-threatening Acanthamoeba keratitis (AK). Recently, AK incidences have been reported with increasing frequency worldwide, particularly in contact lens wearers. In our study, severe cases of AK in Poland and respective pathogenic isolates were assessed at clinical, morphological, and molecular levels. Misdiagnoses and the unsuccessful treatment in other ophthalmic units delayed suitable therapy, and resistance to applied chemicals resulted in severe courses and treatment difficulties. Molecular assessment indicated that all sequenced pathogenic corneal isolates deriving from Polish patients with AK examined by us showed 98-100% homology with Acanthamoeba genotype T4, the most prevalent genotype in this human ocular infection worldwide. In vitro assays revealed that the pathogenic strains are able to grow at elevated temperature and have a wide adaptive capability. This study is our subsequent in vitro investigation on pathogenic Acanthamoeba strains of AK originating from Polish patients. Further investigations designed to foster a better understanding of the factors leading to an increase of AK observed in the past years in Poland may help to prevent or at least better cope with future cases.

Performance of two handheld trace explosives detectors types: SABRE 4000 and MO-2M was compared in terms of the limits of detection determined for: trinitrotoluene, hexahydro-1,3,5-trinitro-1,3,5-triazine, pentaerythritol tetranitrate and nitroglycerin in the particle detection mode. SABRE 4000 detector is a conventional detector based on the ion mobility spectrometry (IMS) and radioactive nickel as the ionization source, whereas in the MO-2M type detector a variant of this technique, viz. the field asymmetric ion mobility spectrometry (FAIMS), and a different β emitter, tritium, as an ionization source are employed. In determining limits of detection the sampling technique was suggested which resorts to binomial distribution for the determination of the indispensable number of positive measurements required to regard a given amount of explosives detected as reliable. Lower limits of detection were achieved in the study for trinitrotoluene and hexahydro-1,3,5-trinitro-1,3,5-triazine with the MO-2M detector (10- and 100-fold, respectively) than with the SABRE detector, whereas for the remaining two substances limits of detection were identical for either detector. The results obtained were discussed in the aspect of the effect of the detector design, ionization mechanism and volatility of substance as the factors that determine the limits of detection values., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

We report a case of a 57-year-old man with typical angina due to a coronary artery-to-pulmonary artery fistula, which was evident on transthoracic and transesophageal echocardiography with color Doppler flow mapping. The diagnosis was confirmed by coronary angiography. The patient underwent surgical ligation of the fistula. However, repeated transesophageal echocardiography and coronary angiography revealed persistence of the fistula with significant left-to-right shunt. The orifice of the fistula was then obliterated by stent-graft implantation, which was proven successful by angiography and echocardiography.

The present study describes development and subsequent validation of high performance liquid chromatographic method (HPLC) in comparison with spectrophotometric methods (classic, first, second and third order derivative) for determination of pure cilazapril in substance and pharmaceutical preparation. The main aim of this study was to find the method suitable not only for determination of cilazapril, but additionally useful in degradation kinetic study. Only the HPLC method is stability indicating. The HPLC method utilizes LiChroCART 250-4 HPLC-Cartridge, LiChrospher 100 RP-18 (5 μm) column, at ambient temperature, eluted at the flow rate 1.0 mL/min. The mobile phase consists of acetonitrile, methanol and phosphate buffer (pH 2.0) (60:10:30, v/v/v). Wavelength of detection is set at 212 nm. Benzocaine is used as an internal standard. The second and third order derivative spectrophotometric methods can be applied for the cilazapril analysis in substance and tablet, but not for stability evaluation (the lack of selectivity towards degradation product).