Tom 132 (2022): Zeszyt 1 (January 2022)

Introduction. Detected in 2019 in Wuhan, China, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing a coronavirus disease 2019 (COVID-19), has changed almost all aspects of human lives. It has had an enormous impact on societies, economies and politics across the world. Nevertheless, first and foremost, it has led to a global health crisis on an unprecedented scale. Since the pandemic’s beginning, one of the greatest global challenges has been to stop the spread of infection among healthcare workers (HCWs). As a front-line fighters, they are at higher risk of contracting SARS-CoV-2 than other professions.

Aim. The study aimed to determine the role of serological testing among HCWs by analyzing screening results for the presence of SARS-CoV-2 antibodies in this group in 12 European countries during the first wave of the pandemic.

Material and methods. Pubmed, MEDLINE, Web of Science, Google Scholar, and WHO COVID-19 databases were searched for studies on screening among HCWs using immunoassays or chemiluminescence assays for preventive purposes and determining the percentage of HCWs with acquired immunity to SARS-CoV-2. The number of 30 papers were selected. Immunoglobulin G (IgG) percentage was analyzed, and determination of immunoglobulin A (IgA) and immunoglobulin M (IgM) antibodies and their diagnostic usefulness.

Results. The screening results of HCWs were juxtaposed with epidemic situation of that time and public health measures in given country.

Conclusion. Introduction of routine serological testing of HCWs could be a valuable strategy to monitor the occupational risk in this group and effectiveness of local epidemic management strategies.

The human gut microbiome is composed of communities of bacteria, viruses and fungi. Bacteria live in each part of digestive tract, increasing their density and changing composition in distal parts. The composition of gut microbiome mainly depends on method of childbirth, age, gender, diet, stress, infections, alcohol intake, diurnal variation, smoking, drugs (antibiotics), physical activity. Dysbiosis is defined as an imbalance or maladaptation in the gut microbial community. This imbalance favors many pathological states and it could be due to some diseases. Non-alcoholic fatty liver disease (NAFLD) has become increasingly common in parallel with the increasing prevalence of obesity and other components of the metabolic syndrome. In year 2020, a more comprehensive new definition of NAFLD was proposed – fatty liver disease associated with metabolic dysfunction (MAFLD). NAFLD/MALFD will become the major form of chronic liver disease in adults and children and could become the leading indication for liver transplantation within a decade. An increased level of Bacteroidetes and decreased level of Firmicutes is observed in fatty liver disease. This imbalance favors the collection of energy and insulin resistance. The prevention and treatment of dysbiosis in NAFLD/MAFLD is essential.

The purpose of this review is an understanding related to the dysbiosis and non-alcoholic fatty liver disease in order to help physicians of different specialties in their clinical practice because of growing in population patients with metabolic syndrome and liver steatosis.

Introduction. The period of socio-professional adaptation is a time when the new employee often feels insecure and is accompanied by emotional tension. Already in the initial period of work, an employee develops a specific attitude towards the environment, which, at a later stage, influences professional development or motivation.

Aim. The aim of the study is to assess the course of the process of social and professional adaptation among nurses who, after graduation, started their first job in hospital departments in the Lubuskie Voivodeship, as well as to characterize the adaptation process and factors influencing its effective course.

Material and methods. The material for the research was collected by means of a proprietary questionnaire. The number of 118 people participated in the study.

Results. There was a statistical dependence between the socio-professional adaptation process and the existence of procedures related to it. Then a relationship was noted between the procedures for the adaptation process and the presentation of the adaptation plan to the new employee. Statistically significant differences were demonstrated by analyzing the feeling of being ready to work independently depending on the duration of the adaptation period in a new workplace.

Conclusion. The adaptation process is often ineffective and important elements, such as access to adaptation procedures, adaptation plan, employee final evaluation, are often overlooked. These elements have a statistically significant impact on the overall assessment of the adaptation process. The adaptation period is often too short, which translates into the lack of readiness to work for new employees.

Smoking is one of the leading causes of death which can be prevented in the developed countries. Smoking begins mainly in adolescence. Smoking in early adolescence is known to be associated with an increased risk of later addiction. Also the growing popularity of e-cigarettes, which attract young people with a variety of flavors, and are still little associated with harmful effects on health, unlike regular cigarettes. Exposure to nicotine in young people can affect learning, memory and attention, and lead to increased impulsivity, mood disorders and drug dependence. Nicotine and its derivatives are harmful to the human body, causing a significant increase in blood pressure, deterioration of blood supply to the vessels and acceleration of atherosclerotic processes, it has a detrimental effect on the gastric mucosa, causing gastric disorders. In addition, smoking is associated with the risk of many cancers: oral cavity, larynx, esophagus, lung, pancreas, kidney, liver and bladder. Nicotine addiction causes many health, social and financial consequences for the individual and the community as a whole. Multiple nicotine addiction risk SNPs were found in the CHRNA5/A3/B4 gene cluster, with the best reported results for the risk allele derived from the non-synonymous SNP, rs16969968, in CHRNA5. Therefore, in the problem of addiction, including nicotine addiction, it seems important to know the neurobiological factors, including genetic ones, involved in these processes. This could lead to the development of new pharmacological and behavioral treatment strategies in the future.

Opioid receptors belong to the group of Gi and Go coupled receptors, inhibiting the activity of the neuron. Opioid receptors regulate reward and aversion. The opioid system contributes to self and species survival by promoting reward elicited by natural stimuli (such as food, sex and social interaction), regulating mood states and facilitating efficient coping with pain and stress. It is suggested that OPRM1 polymorphism is associated with alcohol consumption especially increased in the case of G alleles subjects than A-alleles homozygotes. In several studies, OPRM1 methylation was suspected to be predictive factor of opioid dependence in pain treatment.

The relationship of postoperative or preoperative pain with methylation of some CpG sites in the OPRM1 promoter has also been demonstrated. It is known that OPRM1 SNPs provide changes in the structure of the MOR receptor, so by confirming the pharmacogenetic effects of OPRM1 polymorphisms and using these results to guide therapeutic decisions, patients can be prescribed treatment options with the best efficacy and greatest tolerance. Pharmacogenomics of OPRM1 can improve pain management by predicting individual response to pain medications before treatment and facilitate the development of new and more effective pain medications for post-operative pain.

In 2008 the WHO published a report on infectious diseases against which there is no effective treatment or vaccines and therefore – diseases able to cause pandemic. In addition, so called disease X was mentioned – potentially deadly, with no herd immunity against it, holding pandemic potential, unknown in medicine yet. In 2019 such disease X was COVID-19. There is a plausibility, that next pandemic will be induced by zoonotic RNA virus (alike SARS-CoV-2) infecting people in place of intensified human-animal contacts (like high-density animal farming) without proper legal regulations in terms of animal husbandry and high population density. Also in the past major pandemics in XX and XXI centuries were result of zoonotic transmissions (HIV/AIDS, SARS, MERS, Spanish flu, avian flu, swine flu, Ebola). The key in risk recognising is governments and international healthcare agencies’ reaction – proper countermeasures to control pandemic range should be taken. Animal trade should be legally regulated and deforestation limited. There is also an urgent need for funding R&D studies on diseases listed by the WHO.

Introduction. Burnout and empathy affect employees in social professions due to the demanding work environment. Characterized, among others, by: stress, experiencing failure, workload and its multitasking. At the same time, social professions require high interpersonal skills, active listening, communication, empathy, patience and interest from people who practice them.

Aim. The aim of the study was to analyze the influence of occupational burnout on showing empathy among medical personnel towards patients.

Material and methods. The research was conducted among a group of 104 nurses and 103 doctors, working in hospitals and clinics located in urban areas. The nurses’ mean age is 37,35 (SD=11.32), the doctors’ mean age is 32.50 (SD=8.29).The surveyed persons completed a set of questionnaires: Self-authorship sheet for collecting sociodemographic data, Link Burnout Questionnaire by Massimo Santinello, and Personal Empathy Questionnaire by Zenon Uchnast.

Results. The conducted research shows a negative correlation between occupational burnout and the empathy of medical personnel. Research also shows that burnout affects younger medical staff with a short period of work and wage-driven. On the other hand, empathy is visible above the age of 40.

Conclusion. The research deepened the knowledge about the factors of burnout, which have an impact on the negative perception of development opportunities, failure to perceive work efficiency and the perception of the professional situation as significantly exceeding the individual’s abilities. Negative correlations between burnout and staff empathy indicate a lack of burnout in empathetic people. However, you should bear in mind that having mature empathy protects you from burnout.

Introduction. Several studies analyzed the gender differences in masticatory muscle activity. Previous scientific reports indicate the predominance of the masseter muscle activity in male subjects and the predominance of the temporalis anterior in women. However, there is a lack of studies analyzing the differences in the activity of the mandibular abduction muscles between men and women.

Aim. The presented study evaluated the sex differences in activity within temporalis anterior, masseter, and digastric muscle in healthy young adults.

Material and methods. Thirty-six healthy young adults aged 20 to 29 years (mean 22±2.6 years) were qualified for the presented study. The subjects were divided into two equal groups (n=18) in terms of gender. The masticatory muscle activity was recorded within the temporalis anterior (TA), the superficial masseter muscle (MM), and the anterior bellies of the digastric muscle (DA). Electromyographic activity was recorded in three conditions: at rest, during maximum voluntary clenching at the intercuspal position, and during maximum voluntary clenching with cotton rolls between teeth.

Results. Significant differences in electromyographic activity between the male and female group were observed within resting activity for the TA-R (Women: 1.98 µV vs. Men: 1.26 µV; p=0.000), TA-L (Women: 2.13 µV vs. Men: 1.33 µV; p=0.000), DA-R (Women: 2.17 µV vs. Men: 1.29 µV; p=0.001), DA-L (Women: 2.13 µV vs. Men: 1.37 µV; p=0.005). Moreover, significant difference in resting activity index was observed within left side (Women: -9.89 % vs. Men: 10.39%; p=0.037), and within right side during clenching with cotton rolls between teeth (Women: 9.83% vs. Men: 25.59%; p=0.016).

Conclusions. Women represent higher resting sEMG activity within the temporalis anterior and digastric muscles than men. Electromyographic patterns may be influenced by gender at rest and during clenching tasks.

Introduction. Adjudication of disability in Poland is carried out by independent institutions, operating within the framework of various judicial systems and on the basis of different legal regulations. In 2017, an inter-ministerial team was appointed whose task was to develop a coherent and modern system of adjudicating on disability and inability to work.

Aim. The aim of the study was to obtain the opinion of the management of Disability Adjudication Boards in Poland whether there is a need to reform the certification of disability.

Material and methods. The research questionnaire was sent to 294 boards. In total 66 responses were obtained, which is 23.5% of the invitations.

Results. Over 65% of respondents indicate the need for reform, while 28.8% believe that the reform is unnecessary. The weaknesses of the current system include the inability to recruit appropriate doctors and specialists – 90.9%, insufficient financing of teams – 81.8% and staff shortages among full-time employees – 57.6%. Fewer respondents indicate unclear criteria for assessing disability – 47% and poor preparation of assessments – 21.2%. The strengths of the system are dominated by organizational factors: employee preparation – 77.3%, organizational stability of the system – 59.1% and locating teams in the local government structure – 51.5%. The following factors can be considered as substantive: stability of regulations – 39.4% and quality of jurisprudence – 34.8%.

Conclusions. Majority of the respondents see the need for the reform of adjudication on disability. The greatest problems of disability adjudication boards in Poland are: difficulty in specialists’ recruitment and insufficient financing.

Introduction. The European Code Against Cancer recommends protection from overexposure to ultraviolet (UV) light to reduce the risk of developing skin cancers. The most harmful sub-range of UV is UVB.

Aim. The aim of the study was to collect information on the available means of protection against solar radiation, in particular UV filters, and the mechanism of their action.

Material and methods. Together 24 publications and 2 legal acts on UV filters were analyzed.

Results. Chemical filters are aromatic molecules, the carboxyl group of which under the influence of energy from absorbed radiation undergoes isomerization. The substances classified as chemical filters are para-aminobenzoic acid (PABA), p-methoxycinaminic acid derivatives and octocrylene. Physical or mineral filters include substances of mineral origin. Two types of products are used: colored pigments with a particle size of 200-300 µm and „micronized” zinc oxide or titanium oxide pigments with a particle size of 20 to 80 nm. This group includes titanium oxide, zinc oxide, iron oxides and mica-titanium oxide system.

Conclusions. Chemical and physical UV filters differ in the way they work and range of possible side effects. Most often the sunscreens available on the market contain chemical UV filters or a mixture of chemical and physical ones.

Strengthening of the professionalism of public health (PH) specialists may be the response to changes in health care systems. The aim of the study was to explore the potential and restrictions associated with job search by PH graduates, as well as to examine their opinions on their position on the labor market. The survey was conducted using questionnaire (CAWI) on 107 respondents from two medical universities in 2019. The average age of the respondents was 24.5. 5.61% and 17.76% of graduates from both universities respectively declared that the university prepared students well. Most respondents indicate internships, apprenticeships organized by employers (78%) and accepting graduates without professional experience (64%) as employers’ activities which facilitate entering the labor market. Graduates considered the most important obstacles in finding work to be: low interest in PH graduates work, insufficient contacts and relationships and insufficient professional experience. Their competencies do not coincide with the expectations of employers. Employers and universities do not establish sufficient cooperation. Although the dependency between the place of study and the graduates’ perception of the role of university and employers facilitating entry into the labor market and re-selection of the study is not strong, it should not be ignored in shaping education programs.

Introduction. Pathologies in the oral cavity are a visible problem in polish society. The knowledge regarding oral pathologies and a doctor-patient contact are necessary to diagnose and treat efficiently. COVID-19 pandemic limited this contact reducing health control that caused the development of new pathologies. Those limitations touched dentists making the efficient diagnosis and treatment difficult.

Aim. The aim of this study was to examine the influence of COVID-19 on the accessibility of dental procedures and the development of oral pathologies.

Material and methods. The survey took place during Students’ Science Club Fair at the Medical University in Lublin on 5th November 2021 and in the following days among students of the Medical University in Lublin and other universities in Poland. 102 respondents answered 8 questions anonymously.

Results. The answers’ analysis showed that 74,5% of the respondents do regular dental check-ups at least once a year. Due to the pandemic 27,5% had to change the date of at least one appointment. 47% admitted that the access to dental offices during the pandemic was difficult. 67,6% noticed the rise of the prices of dental procedures. 72,5% declared the lack of new oral pathologies and 26,5% confirmed the appearance of new symptoms in the oral cavity.

Conclusions. The high percentage of dentists in Poland explains why the society is used to an easy access to dental procedures. Dental offices’ accessibility was limited due to the pandemic which was felt by the respondents as a rise in prices and a decrease of the availability of the dentists in that period. Those limitations resulted in the diagnosis of new pathologies.

Despite the development of medicine, acts of violence against health care professionals, are a current, frequent and widespread phenomenon. In Poland, many health care staff are entitled by law to legal protection provided for public officials. Therefore, criminal offenses against them are more severely punished. In the years 2018-2019, research was carried out on acts of aggression that had been experienced by a group of 249 health care staff in health care facilities in the Świętokrzyskie Voivodeship. Just slightly more than 7.5% of the respondents indicated that they had not experienced aggression, which only confirms the scale of the problem. Therefore, managers of health care facilities should use all possible means to limit the extent of attacks and prevent their possible consequences..

Introduction. Estimating the impact of short-term exposure on health outcomes needs knowledge of both the profile and magnitude of the relative risks. This motivates constructions of practical and reliable concentration-response functions (C-RFs).

Aim. To define a practical method of finding concentration-response parametric function whose adjustable parameters can be tuned by data-driven well established routines.

Material and methods. Mortality data for the period from 1987 to 2015 (10,592 consecutive days) in Montreal, Canada, are used for illustrative purposes. Exposure to ambient ozone measured by its concentration levels is considered health risk. Concentration-response function is built using statistical modelling, conditional Poisson regression, natural spline technique, and a rudimentary hierarchical data clustering. The case-crossover design is applied to fit the model of C-RF to the mortality data consisting of daily counts of non-accidental deaths.

Results. Log-linear models of the concentration-response functions were computed for the concentrations and cofactors data lagged by 0 to 7 days; the results were statistically significant within this range of lags. The effectiveness of fitting was confirmed by reliable statistical tests. Digital routines were created to perform all computational tasks; software codes (written for R software platform) are included. The C-RF specifying the current responses to the cumulative exposure in several previous days can be obtained from the responses to lagged exposures.

Conclusions. The proposed method of concentration-response function estimation appears practical and effective in producing reliable results. The constructed function is a parametric and monotonic non-decreasing.

Introduction. There is a large body of research which suggests that air pollutants might affect infectious diseases, their transmission, severity, and a length of recovery.

Aim. The aim of this study is to examine the relationships between ambient air pollution and emergency department (ED) visits for influenza and viral pneumonia in Toronto, Canada.

Material and Methods. The National Ambulatory Care Reporting System database was used to drawn ED visits (4 282 days). Five ambient air pollutants: carbon monoxide, nitrogen dioxide, sulphur dioxide, ozone (CO, NO₂, SO₂, O₃, O₃H₈ – ozone as a maximum eight hour average, respectively), and fine particulate matter (PM_2.5) were examined. In addition, the Air Quality Health Index (AQHI; combines NO₂, O₃, and PM_2.5) was tested. Conditional Poisson models were constructed using daily counts of ED visits. Temperature and relative humidity in the models were represented by natural splines. Air pollutants and weather factors were lagged by 0 to 14 days. The analysis was done by strata of age group, sex, and two seasons.

Results. In the period of the study, 26,200 ED visits were identified; 13,963 for females and 12,237 for males. For each air pollutant, 270 models were generated (18 strata × 15 lags). Ambient air pollution concentrations lagged by 10 and 11 days have the highest impact on ED visits, with 48 and 47 positive associations, respectively. Ozone has 181, sulphur dioxide has 104, and PM_2.5 has 76 among the 417 total positive statistically significant (P-Value<0.05) associations. For all persons an increase (12.8 ppb) in ambient ozone lagged by 0, 1, and 2 days gives the following relative risks and their 95% confidence intervals 1.214 (1.135, 1.299), 1.200 (1.121, 1.284), and 1.179 (1.102, 1.263), respectively.

Conclusion. The results suggest that exposures to urban ambient air pollution affect the number of ED visits for viral respiratory illness.