rss_2.0Postępy Higieny i Medycyny Doświadczalnej FeedSciendo RSS Feed for Postępy Higieny i Medycyny Doświadczalnejępy Higieny i Medycyny Doświadczalnej Feed health problems and their management in patients with Down Syndrome—a narrative review<abstract> <title style='display:none'>Abstract</title> <p>Patients with Down Syndrome (DS) commonly exhibit various anomalies in the masticatory organ and oral cavity. This paper aims to consolidate information regarding oral health challenges faced by individuals with DS, along with strategies employed for their management and care. Our review, conducted via PubMed and Scopus, spanned the period from January 1977 to December 2023. It included original research articles and comprehensive reviews focusing on both pediatric and adult populations. The paper analyzes 71 articles, categorizing them into six sections: oro-facial problems, tooth conditions, dental and skeletal age, dental caries, periodontal diseases, swallowing, masticatory muscles, salivation, behavior management, physical therapy, and early intervention. Understanding oral health issues in individuals with DS is crucial for providing tailored dental care and treatment planning. Regular dental assessments, early intervention strategies such as physiotherapy and behavioral management, and a collaborative approach involving oral health professionals, caregivers, and the individuals themselves are critical to preventing oral health issues and improving overall health and well-being in people with DS.</p> </abstract>ARTICLEtrue mechanisms of colistin resistance mediated by genes in isolated from patients hospitalized in Isfahan medical centers<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Introduction</title> <p>In recent years, colistin-resistant <italic>Acinetobacter baumannii</italic> (<italic>A. baumannii</italic>) has been found all over the world. In this current study, the main purpose was to examine the occurrence of extensively drug resistant (XDR), resistance to colistin and characterization and mutations in <italic>pmrCAB</italic> genes among <italic>A. baumannii</italic> obtained from inpatients.</p> </sec> <sec><title style='display:none'>Materials and Methods</title> <p>A total of 108 clinical isolates of <italic>A. baumannii</italic> were collected from several hospitals located in Isfahan, Iran. The Kirby-Bauer assay was performed to assess the antimicrobial resistance. The Phoenix automated system was utilized to determine the minimum inhibitory concentration (MIC) of colistin for each of the bacterial isolates. Polymerase chain reaction was used to screen for <italic>pmrCAB</italic> genes that mediate colistin resistance, and sequencing was used to determine the amplicon’s nucleotide sequence.</p> </sec> <sec><title style='display:none'>Results</title> <p>The results revealed that all A. baumannii isolates (100%) were resistant to piperacillin tazobactam, meropenem and ciprofloxacin. All isolates were classified as XDR, with seven isolates being pan-drug resistant (PDR). Colistin resistance (CoR) was found in 6.48% (7/108) of studied isolates, all of which were positive for <italic>pmrCAB</italic> genes. The sequencing results showed a substitution in <italic>pmrB</italic> and two isolates showed a substitution in <italic>pmrC</italic>.</p> </sec> <sec><title style='display:none'>Conclusions</title> <p>In conclusion, this study is the initial report of the existence and mutations of <italic>pmrB</italic> and C genes in the clinical isolate of <italic>A. baumannii</italic> in our region. This outcome highlights the necessity to explore additional mutations in the PMR operon of <italic>A. baumannii</italic> in forthcoming studies. Moreover, our results highlight the high occurrence of XDR-<italic>A. baumannii</italic> strain in Isfahan, Iran.</p> </sec> </abstract>ARTICLEtrue plus TKIs therapy for gastrointestinal stromal tumors<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Introduction</title> <p>In this era of tyrosine kinase inhibitors (TKIs), the clinical benefit of surgery for patients with metastatic or recurrent gastrointestinal mesenchymal tumor (GIST) is not well defined. The aim of our study was to demonstrate the survival advantage of adding surgery in patients with recurrent or metastatic GIST.</p> </sec> <sec><title style='display:none'>Methods</title> <p>A systematic search of PubMed, Web of Knowledge, Ovid’s database was conducted. Relevant studies published by 31 July 2022 on the role of surgery in recurrent or metastatic GIST were identified. Research quality was assessed using the Newcastle-Ottawa Quality Assessment Scale.</p> </sec> <sec><title style='display:none'>Results</title> <p>Eight studies involving 842 patients were included. The four included studies covered 3-year survival and included 441 patients, of whom 302 received TKIs, and 139 received TKIs plus surgery. 3-year overall survival was significantly higher in the TKIs plus surgery group than in the TKIs group (OR=2.37, 95% CI 1.45–3.88, P = 0.001). The 5-year overall survival was 69.0% in the TKIs plus surgery group compared with 49.1% in the TKIs only group. Survival was significantly higher in TKIs plus surgery group (OR = 2.69, 95%Cl 1.49–4.86, P=0.001). Four studies, including 453 patients, indicated 3-year progression-free survival (PFS). The pooled analysis revealed the TKIs plus surgery group did have a better PFS than the TKIs only group (OR = 4.02, 95% CI: 1.45–11.16, P=0.008). Three included studies focused on gastrointestinal stromal tumor liver metastasis (GLM). The role of surgery plus TKIs had statistically significant better 5-year overall survival as compared with TKI treatment alone (OR = 2.34, 95% Cl 1.30–4.22, P=0.005).</p> </sec> <sec><title style='display:none'>Conclusions</title> <p>Treatment with surgical resection and TKIs could significantly improve the prognosis of patients with recurrent or metastatic GIST.</p> </sec> </abstract>ARTICLEtrue influence of intimate hygiene on vaginal microbiota and health<abstract> <title style='display:none'>Abstract</title> <p>There is a direct correlation between the vaginal microbiome and the health of a woman’s reproductive system. The microbiome is mainly composed of lactic acid rods – <italic>Lactobacillus</italic>, the metabolism of which ensures an acidic pH, playing a protective role for vaginal homeostasis. One of the typical disorders of homeostasis is bacterial vaginosis, defined as predominance of group IV CST system bacteria (comprising different genera characterized by anaerobic metabolism), which is an essential problem of the female population all over the world. The maintenance of this homeostasis can be restored by medicinal preparations. In addition to well-known antibiotics aimed at inhibiting the development of bacterial pathogens, probiotics and products that promote the development of beneficial microbiota are increasingly used. It seems more relevant not to cure, but to prevent imbalance of homeostasis. For this purpose, women use different washing and care techniques of external genitalia. Women’s everyday practices also include the use of washing preparations from the group of cosmetics; however, little is known about their impact on the microbiota. These products potentially constitute an element of early prevention, which is highly beneficial for female health. The main controversial type of ingredients are cleaning surfactants, which can lead to disruption of the epidermal barrier and to breakthrough of pathogens.</p> </abstract>ARTICLEtrue of antimicrobial susceptibility, class I, II, and III integrons among clinical isolates of from hospitalized burn patients in Southern Iran<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Introduction</title> <p>Burn infection due to <italic>Pseudomonas aeruginosa</italic> poses a considerable challenge in terms of graft loss, systemic sepsis, prolonged hospital stays, and even enhanced mortality. The aim of this study was to consider the susceptibility pattern to antibiotics and occurrence of class I, II, and III integrons in <italic>P. aeruginosa</italic> isolated from hospitalized burn patients.</p> </sec> <sec><title style='display:none'>Materials and Methods</title> <p>A cross-sectional study was performed on 70 <italic>P. aeruginosa</italic> isolates obtained from blood, wounds, biopsy, and sputum samples from burn patients between January 2020 and March 2021 from different wards of a teaching hospital in Ahvaz, Iran.</p> </sec> <sec><title style='display:none'>Results</title> <p>Antimicrobial susceptibility pattern was performed using the disk diffusion method. Also, PCR was carried out for the detection of <italic>intI1</italic>, <italic>intI2</italic> and <italic>intI3</italic> genes. Among the 70 <italic>P. aeruginosa</italic> isolates, 34 (48.6%) isolates were obtained from females and 36 (51.4%) isolates from males. PCR amplification revealed that 51.4% isolates (36/70) had <italic>intI1</italic>, 30% isolates (21/70) had <italic>intI2</italic>, and 12.9% isolates (9/70) had both genes. However, the <italic>intI3</italic> gene was not detected in any isolates. Furthermore, there is no important association between resistance to antibiotics and the presence of <italic>intI</italic> genes.</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>According to our results, there were no statistically significant differences among resistance to antibiotics and the presence of <italic>intI and intI1</italic> genes. However, the surveillance of patterns of antibiotic resistance and investigation into the role of integrons in controlling the scattering of antibiotic-resistant genes are recommended.</p> </sec> </abstract>ARTICLEtrue of holder pasteurization and storage of donor human milk on survival<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Introduction</title> <p>Human milk, which constitutes the best composed nutrition for infants, is not a sterile biofluid. Besides nutritional and bioactive components, many microorganisms have been found in human milk, including <italic>Bacillus cereus</italic>. Those pathogenic bacteria can be responsible for causing pneumonia or septicemia in neonates. Although <italic>Bacillus cereus</italic> infections are not common, they represent one of the increasing factors of a high mortality rate in the preterm infants group. Donor human milk (DHM) may be a significant source of this pathogen.</p> </sec> <sec><title style='display:none'>Materials and Methods</title> <p>Given the high ability of <italic>Bacillus cereus</italic> spores to survive under different thermal conditions, we tested the effect of the holder pasteurization and storage points (4 °C and −21 °C) on sporulation and vegetative forms’ survival in inoculated human milk samples by culture method and light microscopy.</p> </sec> <sec><title style='display:none'>Results</title> <p>Studies confirmed that holder pasteurization is effective against vegetative forms of <italic>Bacillus cereus</italic>. Additionally, during storage endospores were observed in all analyzed inoculated donor milk samples, both the pasteurized and unpasteurized samples, thus possibly promoting the occurrence of <italic>Bacillus cereus</italic> in DHM.</p> </sec> <sec><title style='display:none'>Conclusions</title> <p><italic>Bacillus cereus</italic> is considered a contamination in DHM and in the human milk banks’ (HMB) environment. There is a need to further develop methods of identifying, transmitting, and preventing bacteria forming spores, which could be applied in HMB.</p> </sec> </abstract>ARTICLEtrue of childhood acute leukemias<abstract> <title style='display:none'>Abstract</title> <p>Acute leukemias are the largest group of childhood cancers. According to the latest WHO data 80,491 leukemias were diagnosed in 2020 alone. In the coming years the incidence worldwide will continue at a similar level. The morbidity correlates with biological determinants such age, gender and race. The etiology of leukemia formation is complex and depends on genetic, physiological, environmental and even prior treatment-related factors. Both the incidence and curability are also influenced by age, gender, and race. The peak of incidence of leukemia occurs between the ages of 1–4 years and 9–19. The etiology of leukemia formation is complex and depends on genetic, physiological, environmental and even prior treatment-related factors. Boys suffer from leukemia more often than girls. In 2020 58.2% of diagnoses were for boys. Numerous factors contribute to the development of acute leukemia. In the case of young children, a notable association exists between acute leukemia and infections caused by viruses such as EBV or HHV-6. Furthermore, the risk of leukemia can be elevated by allergies, which involve Th1/Th2 lymphocyte-dependent mechanisms. A familial predisposition to tumorigenesis in children is observed in Li-Fraumeni Syndrome. Also, genetic diseases such as Down syndrome and Fanconi anemia are associated with an increased risk of acute leukemia. Previous exposure to radiation therapy or the use of anti-cancer drugs can also lead to the development of secondary cancers, including leukemia. The analysis of risk factors can be used to support efforts aimed to reduce potentially harmful exposure and to decrease the risk of disease.</p> </abstract>ARTICLEtrue debate on elimination of dog-mediated human rabies in developing countries by 2030<abstract> <title style='display:none'>Abstract</title> <p>Rabies is a vaccine-preventable viral disease that affects over 150 countries and territories worldwide. This neglected disease is almost always fatal once clinical signs manifest and is thus responsible for approximately 59,000 annual deaths. Due to globalization, rabies continues to be seen as a disease of developing countries and more emphasis, both nationally and internationally, is put on fighting infectious diseases that also affect economically developed countries. Even though the elimination of dog-mediated rabies in Europe and North America has proved the possibility of its eradication, rabies is still a persistent public health concern in low- and middle-income countries. It is believed that the interplay of sustainable investment strategies and rabies education, through developed countries, could positively affect the cooperation of culturally diverse regions and could help garner coordinated action from different areas affected by dog-mediated rabies. Breaking the rabies transmission cycle requires a comprehensive approach that includes increased vaccination efforts, improved surveillance and control of wildlife populations, and public education and awareness. More global effort must be put into these efforts to effectively combat the spread of rabies and protect public health. We herein examine various strategies and innovative financing methods for eliminating dog-mediated human rabies from the developing world to achieve the World Health Organization’s (WHO) goal of zero rabies deaths by 2030.</p> </abstract>ARTICLEtrue ischemic syndrome – case report and literature analysis<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Introduction</title> <p>Ocular ischemic syndrome (OIS) is a rare condition associated with ocular hypoperfusion caused by carotid artery occlusive disease. This article describes the case of a patient who was admitted to the Department of Ophthalmology at UCK in Katowice, Poland, due to significant loss of visual acuity and pain in the right eye.</p> </sec> <sec><title style='display:none'>Materials and Methods</title> <p>Retrosopective case report.</p> </sec> <sec><title style='display:none'>Results</title> <p>Patient showed up in the ophthalmological emergency department complaining of significant loss of visual acuity and pain in the right eye persisting for 2 weeks. The patient had a history of type II diabetes mellitus, hypertension, status post ACS and PCI, and long-term nicotinism. Examination of the right eye revealed ocular irritation, mixed conjunctival injection, hyphema in the anterior chamber, iris neovascularization, and discrete central retinal fading. Additional examinations were performed, including an angioCT, which showed a long-standing obstruction of the right internal carotid artery, a ballooning thrombus in the lumen of the brachiocephalic trunk, and suspected critical stenosis of the left vertebral artery.</p> <p>A neurologist and vascular surgeon were consulted, and treatment was instituted to limit further complications from the underlying disease. The patient remains under close supervision of the vascular surgeon and neurologist.</p> </sec> <sec><title style='display:none'>Conslusions</title> <p>OIS is a rare but potentially blinding condition and should be considered in the differential diagnosis of transient visual acuity reduction or vision loss.</p> </sec> </abstract>ARTICLEtrue antibacterial coating (DAC) hydrogel with gentamycin and vancomycin for the therapy of achilles tendon infection after surgical repair without massive soft-tissue defect. Results in 8 cases<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Introduction</title><p>We report the results of revision surgery in postoperative infection after Achilles tendon (AT) suturing consisting of debridement of AT together with a local application of hyaluronic acid and polylactic acid hydrogel with an addition of gentamicin and vancomycin in suture canals and into an operative wound.</p></sec> <sec><title style='display:none'>Materials and Methods</title><p>A retrospective study included eight patients operated due to a postoperative and unsuccessfully treated infection after AT suture. Before revision with defensive antibacterial coating (DAC) hydrogel, all patients underwent an unsuccessful antibiotic therapy, removal of sutures via the sinus tract. In none of the cases was there a skin defect due to a previous surgery and infection. In all cases, the AT healed at revision surgery, residual stiches were removed, and suture canals and adjacent soft tissue and anchor canals in the bone were debrided and filled with 5 ml DAC hydrogel with an addition of gentamicin and vancomycin.</p></sec> <sec><title style='display:none'>Results</title><p>During the follow-up ranging from 6 to 43 months, all patients obtained a complete resolution of inflammation. No side effects related to DAC hydrogel were observed.</p></sec> <sec><title style='display:none'>Conclusion</title><p>The use of 5 ml antibacterial DAC<sup>®</sup> hydrogel containing 160 mg gentamycin and 50 mg of vancomycin applied during revision surgery on the surface of AT and in suture canals in AT as an adjunct to surgical debridement for infection complicating repair of AT without a massive soft-tissue defect proved to be safe and effective. Level of Evidence: IV (case series).</p></sec> </abstract>ARTICLEtrue the HALP score predict survival in severe COVID-19 pneumonia?<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Introduction</title> <p>The coronavirus infection has caused a pneumonia pandemic worldwide. Our study aimed to determine the relationship between the HALP score and survival in patients monitored in the intensive care unit due to COVID-19 pneumonia.</p> </sec> <sec><title style='display:none'>Materials and Methods</title> <p>Adult patients monitored in our hospital’s COVID intensive care unit between 01.11.2020 and 30.11.2021 were retrospectively evaluated. The effect of the HALP score on survival was investigated with examinations.</p> </sec> <sec><title style='display:none'>Results</title> <p>The death rate in the 103 patients included in the study was found to be 49.5% (n = 51). When evaluated in terms of patients’ gender distribution and median age, no significant difference was observed between survivors and deceased patients (p = 0.20 and p = 0.96, respectively). Ferritin, CRP, LDH and fibrinogen levels were found significantly higher in the deceased patient group compared to the surviving patient group. The median value of the HALP score was significantly higher in the surviving patient group (9.35) compared to the deceased patient group (6.83) (p = 0.015). In the binary logistic regression analysis, HALP score, LDH, and CRP were found to be statistically significant risk factors for mortality.</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>As a result of our study, we believe that the HALP score could be a practical and easily accessible scoring method that can be used to predict survival in COVID-19 patients monitored in the intensive care unit.</p> </sec> </abstract>ARTICLEtrue influence of zinc deficiency on taste disorders in selected medical aspects<abstract> <title style='display:none'>Abstract</title> <p>Taste disorders are a serious impediment to the process of eating meals. There are many mechanisms that determine the development of taste disorders. One of them is believed to be zinc deficiency. Zinc is responsible for the processes of regeneration of taste and smell centres. It plays a significant role in the cells of the taste bud. Our study aims to present the role of zinc deficiency on the occurrence of taste disorders in selected medical aspects, such as in the course of diabetes, as a result of radiotherapy and chemotherapy of head and neck cancers, resulting from old age, and in the course of oral cavity halitosis. The study analyzed articles available in the PubMed database. The consequence of the reduced zinc content is its incorrect amount in the epithelium of the tongue, which may be the result of a reduced ability of cells to regenerate after the destructive effects of pathological factors. The result of zinc deficiency is its reduced amount in the salivary glands, which results in reduced activity of carbonic anhydrase 6 (gustin), which is a component of saliva. Zinc is also involved in the process of experiencing taste by affecting neuronal processes. Zinc ions inhibit oral malodor by binding directly to hydrogen sulfide gas and by inhibiting the growth of oral bacteria that produce volatile sulfur compounds. In the study, we focus on the mechanisms that determine the abnormal perception of taste and potential therapeutic possibilities based on current scientific reports.</p> </abstract>ARTICLEtrue of the effects of orbital decompression in Graves' ophthalmopathy<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Introduction</title><p>Graves' disease is an autoimmune disorder. One of the symptoms is an overgrowth of the soft tissues of the orbit. Orbital involvement can cause exophthalmos, diplopia, or vision loss. Treatment strategies include a surgical approach that limits the ailments mentioned above. Decompression can be achieved by reducing the amount of enlarged tissues (fat removal) or increasing the space for enlarged tissues (bone removal). Numerous authors discuss the advantages and disadvantages of various techniques in terms of reducing the exophthalmos, the number and persistence of complications, and the long-term prognosis.</p></sec> <sec><title style='display:none'>Materials and Methods</title><p>A literature search of PubMed and the Poznan University of Medical Sciences Main Medical Library resources from 1993–2022 was performed. Thirty articles were reviewed with attention to the surgical treatment of Graves' ophthalmopathy.</p></sec> <sec><title style='display:none'>Results</title><p>The main surgical techniques include fat decompression and bone wall decompression. The results of exophthalmos fat removal are characterized by a significant decrease in proptosis (5.45mm) with a small percentage of newly formed diplopia (9%). Bone reduction in the lateral wall of the orbit shows similar effects: reducing exophthalmos (4.33mm) and the newly formed diplopia, as with fat removal (3.7%). Bone reduction in the medial- lateral wall, medial- inferior- lateral wall, and medial–inferior wall shows a decrease in proptosis ( 4.9 mm, 4.6 mm, 3.77 mm) and a higher percentage of new-onset diplopia (18%, 15%, 28%).</p></sec> <sec><title style='display:none'>Conclusion</title><p>The smallest amount of newly formed diplopia at the highest proptosis reduction occurs with the self-removal of fat or resection of the lateral orbital wall.</p></sec> </abstract>ARTICLEtrue extracellular traps (NETs) in aortic stenosis: Comparison of methods for assessment of NETs formation<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Introduction</title> <p>We previously showed increased neutrophil extracellular traps (NETs) formation (NETosis) in patients with severe aortic stenosis (AS). Our aim was to comprehensively assess NETosis in AS using a relatively simple and appropriate technique. We investigated circulating NETosis markers by ELISA and assessed the potential of blood neutrophils to release NETs by flow cytometry.</p> </sec> <sec><title style='display:none'>Materials and Methods</title> <p>We enrolled 13 patients aged 66 [Q1–Q3, 60–70] years with severe isolated AS without diabetes, chronic kidney disease, and atrial fibrillation. Nine apparently healthy volunteers of similar sex and age served as controls. Serum concentrations of citrullinated histone H3 (citH3), circulating nucleosomes, myeloperoxidase (MPO), and deoxyribonuclease-1 (DNASE1) were measured using ELISAs. Peripheral blood NET-releasing neutrophils were detected by flow cytometry as MPO/citH3-positive cells.</p> </sec> <sec><title style='display:none'>Results</title> <p>AS patients compared to controls presented 174% higher concentrations of citH3 (p&lt;0.001), 456% higher nucleosomes (p&lt;0.001), 136% higher MPO (p=0.021) and 19% higher DNASE1 levels (p=0.039), together with 101% elevated percentage of NET-releasing neutrophils assessed by flow cytometry (p=0.003). In AS patients, the proportion of blood NET-releasing neutrophils positively correlated with citH3 (r=0.86, p&lt;0.001) and nucleosome (r=0.58, p=0.041) concentrations but not with MPO or DNASE1. Moreover, we observed a strong association between AS severity, measured as aortic valve area (AVA), and serum citH3 concentrations (r=−0.75, p=0.003), but not the number of NET-releasing neutrophils.</p> </sec> <sec><title style='display:none'>Conclusions</title> <p>Our study showed increased blood neutrophil potential to release NETs together with increased levels of serum markers of NETos is in severe AS patients. However, we recommend ELISA to assess NETosis in vivo as simpler technique giving more unequivocal results compared to flow cytometry.</p> </sec> </abstract>ARTICLEtrue many is good enough? An analysis of serological follow-up after vaccination against SARS-CoV-2<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Introduction</title> <p>Despite vaccinations available worldwide, patients and healthcare workers still struggle with COVID-19. Previously we observed in some convalescents surprisingly lower antibody levels after a second dose of SARS-CoV-2 vaccine compared to the first dose. Six months after full vaccination we obtained follow-up results of 87 patients divided into 3 groups: (A) convalescents with higher antibody levels after second dose of vaccine compared to first dose, (B) naïve patients, (C) convalescents with decreasing antibody level after second dose compared to first dose.</p> </sec> <sec><title style='display:none'>Materials and Methods</title> <p>Patients’ anti-SARS-CoV-2 antibody levels were checked by the anti-SARS-CoV-2 QuantiVac ELISA (IgG) (EUROIMMUN MedicinischeLabordiagnostica AG, Luebeck, Germany) test, as before, and prior to the blood sampling patients completed a questionnaire regarding, inter alia, general condition, smoking, flu vaccination.</p> </sec> <sec><title style='display:none'>Results</title> <p>Thanks to this follow-up we concluded that none of the patients suffered from symptomatic SARS-CoV-2 infection within 6 months after vaccination. Decline of antibody levels 6 months after vaccination was observed in all groups. Convalescent group A lost more antibodies in the mentioned period of time than group B or C. Group C presented still high results, higher than in group B (p = 0.007), but lower than in group A (p = 0.048).</p> </sec> <sec><title style='display:none'>Conclusions</title> <p>Temporary decrease of antibody levels in convalescents after the second dose of SARS-CoV-2 vaccination did not imply further consequences in the form of important antibody level differences 6 months after vaccination. Patients’ overweight could have an impact on antibody production but only after natural infection. It did not affect obtained results after vaccinations.</p> </sec> </abstract>ARTICLEtrue against influenza and attitudes towards seasonal vaccination of medical students from the Medical University of Silesia<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Introduction</title> <p>To reduce the incidence of influenza, healthcare workers and medical students are recommended to receive annual seasonal vaccination. This study aimed to investigate the behavior of students regarding their willingness to be vaccinated against influenza and the attitudes influencing their approval or disapproval of influenza vaccination.</p> </sec> <sec><title style='display:none'>Materials and Methods</title> <p>This cross-sectional study was designed as an online survey among students of the Medical University of Silesia (MUS) of all years and specialties, as MUS is the largest medical college in Poland. A total of 302 students participated in the study and completed an online questionnaire. The collected data were analyzed using descriptive and analytical statistics. The significance of the differences was tested using the chi-square test.</p> </sec> <sec><title style='display:none'>Results</title> <p>The percentage of students who received influenza vaccinations in the past was 42.1%, and in the current influenza season (Autumn 2022) was 33.4%. The level of vaccination differed significantly depending on the study program <italic>(p &lt; 0.001).</italic> An important variable affecting the decision to vaccinate was participation in clinical classes. Among the students taking practical classes, 59.4% were vaccinated. Most respondents had a positive opinion about influenza vaccination (98%). Belief in the effectiveness of vaccination (35.6%) was the main reason for vaccination against influenza, as indicated by the respondents. The main reason for not being vaccinated was a lack of fear of influenza infection (22.9%).</p> </sec> <sec><title style='display:none'>Conclusions</title> <p>The results obtained in this study indicate the need to introduce changes in the field of broader education regarding the effectiveness of vaccinations in reducing the number of influenza virus infections among medical students.</p> </sec> </abstract>ARTICLEtrue colistin susceptibility results determined in multidrug resistant Gram-negative bacteria be used for polymyxin B?<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Introduction</title> <p>The present study aimed to compare the MIC values of colistin and polymyxin B in fermentative and non-fermentative Gram-negative bacteria and to examine whether the susceptibility results determined with colistin can be used for polymyxin B.</p> </sec> <sec><title style='display:none'>Materials and Methods</title> <p>A total of 268 strains of <italic>Escherichia coli</italic> (<italic>E. coli</italic>), <italic>Klebsiella pneumoniae</italic> (<italic>K. pneumoniae</italic>), <italic>Pseudomonas aeruginosa</italic> (<italic>P. aeruginosa</italic>), <italic>and Acinetobacter baumannii</italic> (<italic>A. baumannii</italic>) isolates were included in the study. The reference broth microdilution and the results were evaluated according to CLSI recommendations.</p> </sec> <sec><title style='display:none'>Results</title> <p>Of the 268 strains, 40.7% were found to be colistin resistant and 34% polymyxin B resistant. Essential agreement (EA) and categorical agreement (CA) ratios for all isolates were found to be 81.3% and 85.1%, respectively. Identical MIC values were found for colistin and polymyxin B in 104 isolates (38.8%), and this rate was 31.1% and 48.7% in Enterobacterales and non-fermentative bacteria, respectively. Colistin resistance rates were 25.4% for <italic>E. coli</italic>, 67.4% for <italic>K. pneumoniae</italic>, 23.8% for <italic>P. aeruginosa</italic>, and 31.5% for <italic>A. baumannii</italic>. Polymyxin B resistance rates were 18.6% for <italic>E. coli</italic>, 64.1% for <italic>K. pneumoniae</italic>, 19% for <italic>P. aeruginosa</italic>, and 16.7% for <italic>A. baumannii</italic>.</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>According to the results of the study, it was concluded that the MIC values of colistin and polymyxin B antibiotics in all bacteria were not compatible with each other. Colistin susceptibility results cannot be used for treatment with polymyxin B, despite CLSI's recommendation.</p> </sec> </abstract>ARTICLEtrue there a link between obesity phenotype and thyroid diseases? A mini-review of current concepts<abstract> <title style='display:none'>Abstract</title> <p>Obesity is a chronic, relapsing, and progressive disease that leads to negative health consequences. Excessive adiposity frequently coexists with metabolic and nonmetabolic complications, deteriorating health and reducing quality of life and life span. Individuals with obesity are not a homogenous group and can present different obesity phenotypes. The most common obesity phenotypes include: metabolically healthy obese (MHO) and metabolically unhealthy obese (MUO). The latter category involves those with developed metabolic syndrome (MetS) and non-fully-developed metabolic syndrome (pre-MetS). The fundamental factor leading to obesity is imbalance between energy uptake and expenditure. From this perspective the thyroid gland plays the pivotal role in metabolism regulation and obesity development. The thyroid regulates thermogenesis, appetite, and lipids turnover. Clinically, hypothyroid patients have decreased metabolic rate and subsequently experience increase of BMI and excess adiposity. The interaction between the thyroid gland and obesity is bidirectional. Several mechanisms of alteration of the hypothalamus-pituitary-thyroid axis in obesity are proposed. Excessive adiposity and dysfunction of adipose tissue may contribute to the development of thyroid functional and structural impairment, such as autoimmunity, thyroid nodules, and thyroid cancer. The prevalence of certain thyroid disorders in obese individuals is higher than in nonobese subjects and this trend is more pronounced in unhealthy obesity phenotypes. The aim of this mini-review is to present the current knowledge on the interaction between thyroid gland disorders and obesity, with special focus on obesity phenotypes.</p> </abstract>ARTICLEtrue influence of reinnervation on the results of peripheral nerve repair after injuries<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Introduction</title> <p>Research on the possibility of increasing the effects of after-injury reconstruction of peripheral nerves conducted in the Department of Physiology at ŚUM resulted in the development of a new method of reconstruction after peripheral nerve injuries. In this new method, we used 7-day predegenerated <italic>in situ</italic> sural nerve grafts. In clinical assessment, we concluded that recovery in motor, sensory and vegetative function after peripheral nerve injury treatment is better with the use of predegenerated grafts. The latent efficacy of reconstruction was measured months or years after reconstruction. In that amount of time, denervated synaptic sites in muscles can be reinnervated by nearby healthy non-injured nerves. It could increase motor, sensory, or vegetative function, irrespective of the effects of chirurgical treatment. We decided to investigate whether the circumstances may influence the latent efficiency of the new method of reconstruction.</p> </sec> <sec><title style='display:none'>Materials and Methods</title> <p>Experiments were carried out on 32 patients in The Department of Neurosurgery Medical University of Silesia. Twenty patients were operated on with a predegenerated (P) implant, and 12 patients operated in the traditional method (T). As a result, 25% of patients’ reinnervation from healthy nearby nerves in the area supplied by reconstructed nerves was present. In group P, reinnervation appeared in 7 of 20 patients (35%) and in group T, in 1 from 12 (8.33%) cases.</p> </sec> <sec><title style='display:none'>Results</title> <p>Results of the examinations were counted statistically in both groups.</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>Reinnervation from nearby healthy non-injured nerves positively influences the results of human peripheral nerve reconstruction.</p> </sec> </abstract>ARTICLEtrue patient infected with SARS-Cov-2 presents with DIHS syndrome induced by olanzapine: diagnostic difficulties<abstract> <title style='display:none'>Abstract</title> <p>Drug-induced hypersensitivity syndrome (DIHS) is a potentially life-threatening reaction. The pathology of DIHS has been connected with adverse reactions to drugs; however, it has been observed that viruses and other infectious factors may induce similar responses in the body. COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has recently become a major challenge for worldwide healthcare. The dermatological symptoms occur in approximately 5.95% of COVID-19 patients, however, they are not exclusively a manifestation of SARS-CoV-2 infection.</p> <p>Certain skin-related symptoms might result from therapeutic drug administration, personal protective equipment, or sanitizers used by medical personnel. The complex pathomechanism of those symptoms leads to multiple diagnostic difficulties. This article describes a case of a 40-year-old man who was admitted to the intensive care unit (ICU) due to heavy respiratory failure in the course of SARS-CoV-2 infection. The patient has been treated with olanzapine for anxiety disorder for approximately 4 years. On the seventh day of treatment, the patient presented with a maculopapular rash, fever, and swollen upper lip. Because of these presented symptoms, the patient has been diagnosed with drug-induced hypersensitivity syndrome (DIHS). The results of blood analysis showed elevated levels of acute phase markers, liver and kidney damage markers, which are present both during COVID-19 and DIHS. Furthermore, the patient presented with peripheral eosinophilia, which is a distinctive feature of DIHS. In the course of COVID-19, the laboratory-measured levels of eosinophilic granulocytes declined to 0. Therefore, in the active phase of SARS-CoV-2 infection, the eosinophilia connected with DIHS was difficult to assess. In this paper, we compare and contrast the clinical and laboratory symptoms of COVID-19 and DIHS syndrome, describe patient's case and explain the diagnostics difficulties resulting from the concomitance of those disease entities.</p> </abstract>ARTICLEtrue