Impact of COVID-19 Pandemic on Health and Life Emergencies Resulting from Illness Cases and Injuries-A Preliminary Study.

Background: Despite organised efforts, the COVID-19 pandemic had a significant impact on the health status of the population and health services including the emergency medical system. The objective of the study was to investigate, based on the Emergency Medical Teams' (EMT) interventions, the impact of the COVID-19 pandemic on health and life emergencies resulting from illness cases and injuries of Polish females and males. Material and Methods: The data under analysis concern EMT interventions carried out in central and eastern Poland from 1 January 2017 to 31 December 2022 (n = 226,038). The study used descriptive statistics, the Mann-Whitney U Test, and the Chi-square test. Results: A significant increase was observed in the proportion of EMT interventions (p < 0.001) to patients with illness cases (80.30% vs. 83.17%) and a decrease in interventions to patients with injuries (19.70% vs. 16.83%) during the pandemic as compared to the pre-pandemic period. As for illness cases, the patients' ages during both periods were similar (Me = 66.00 vs. 66.00, p = 0.071). On the other hand, during the pandemic, injuries mainly affected elderly patients as compared to the pre-pandemic period (Me = 50.00 vs. 47.00, p < 0.001). The increase in the proportion of EMT interventions to patients with illness cases and the decrease in patients with injuries during the pandemic, as compared to the pre-pandemic period, concerned the area of intervention, patient's sex, and age. During the pandemic period, a significantly lower proportion of patients transported to the hospital (p < 0.001) and an increase in the proportion of patients left at the place of call (p < 0.001) were noted. Conclusions: The restrictions aimed at preventing the spread of the SARS-CoV-2 virus contributed to a reduced number of injuries without, however, reducing the number of illness cases. During the pandemic, the elderly were affected by injuries. The study indicates the need for further in-depth analyses to prepare the pre-hospital care system in Poland for the occurrence of other or similar emergencies.

ICD-10 Classification in the Practice of Emergency Medical Teams: New Insights.

The role of the emergency medical system is to provide assistance to every person in a state in the event of a sudden threat to health and life. Emergency medical teams (EMTs) are an important element of this system, making diagnoses based on the International Classification of Diseases (ICD-10). The study was aimed at analysing the causes of EMT intervention based on groups of diagnoses codified according to the ICD-10. The analysis was based on data from 116,278 EMT interventions in central-eastern Poland in 2017-2019. The research showed that EMT most often made diagnoses based on groups of ICD-10 codes: R00-R99-Symptoms, signs, and abnormal clinical and laboratory findings, not elsewhere classified (39.11%); S00-T98-Injury, poisoning, and certain other consequences of external causes (18.23%); and I00-I99-Diseases of the circulatory system (15.57%). The analysis of the obtained results showed statistically significant differences (p < 0.0001) regarding the area of intervention (urban, rural), sex, age of the patient, and the method of completion of the activities by EMTs in relation to the group of ICD-10 diagnoses for the diagnosis. The conducted study showed the actual reasons for EMT calls. The use of the ICD-10 classification has practical application in EMTs, as it enables the identification of a disease or health problem.

The Effect of Neoglandin on the Activity of N-Acetyl-ß-D-Hexosaminidase in the Serum and Urine of Alcohol-Dependent Men.

Dietary supplementation of gamma-linolenic acid (GLA) in the form of a commercial drug neoglandin (containing GLA and vitamin E), in people following alcohol abuse allows bypassing of the ineffective delta-6-desaturase system involved in the transformation of linoleic acid into GLA. Determination of the activity of N-acetyl-ß-D-hexosaminidase (HEX) in the serum and urine reflects neoglandin action on the catabolism of glycoconjugates and the functioning of liver and kidneys in people following alcohol abuse. MATERIAL AND METHODS: The serum and urine were collected from men with alcohol dependence, treated (n = 31, age 33.16 ± 9.72 years) and not treated (n = 50, age 35.46 ± 11.37 years) with neoglandin. HEX activity were assayed in the supernatants by the colorimetric method, with the p-nitrophenyl derivative of sugar as substrate. RESULTS: Our study on alcoholic men not treated with neoglandin indicates a significantly higher concentration of the serum and urinary HEX activity (nKat/L) on day 1 compared to days 7, 10, 14 and 30 (p < 0.001). For days 14 and 30 (p < 0.01), the urinary HEX activity was expressed in µKat/kgCr. No significant differences were observed in the activity of serum (nKat/L) and urinary (nKat/L and µKat/kgCr) HEX in alcoholics during treatment with neoglandin compared to day 1 of neoglandin treatment. We found significantly different (p < 0.05) concentration of HEX activity (nKat/L) in serum of alcohol-dependent men treated with neoglandin compared to those not taking neoglandin on days 7, 10, 14 and 30 of treatment. The urinary concentration of HEX activity (nKat/L) on days 1, 4, 10 and 30 and HEX activity in µKat/kgCr on days 1, 4 and 7 it was significantly higher (p < 0.05) during the treatment of alcohol-dependence without the use of neoglandin as compared to alcoholics treated with neoglandin. We found a positive correlation between the amount of alcohol consumed and the urinary activity of HEX in the early phase after alcohol withdrawal and a lack of correlation between the HEX activity in serum and urine of alcohol-dependent men not treated with neoglandin. CONCLUSIONS: Neoglandin supplementation in alcoholic men significantly slows down the catabolism of glycoconjugates, thus reducing the effects of ethanol poisoning that are harmful to the kidneys. Neoglandin reduces the harmful effects of ethanol poisoning more on the kidneys than on the liver. The activity of HEX in the serum may be used in monitoring the treatment of alcoholism and whether alcohol reuse occurred during the therapy. In the early stages of alcohol withdrawal, urinary HEX activity can be used as a marker of the amount of alcohol consumed during previous alcohol abuse.

Characteristics of Emergencies in the Workplace from the Perspective of the Emergency Medical Services: A 4-Year Case-Control Study.

INTRODUCTION: Accidents and emergencies in the workplace account for a significant proportion of emergency calls worldwide. The specificity of these events is often associated with hazards at a given workplace. Patients do not always require hospitalization; therefore, the characteristics of events can only be determined from the perspective of emergency medical services teams. The aim of the study was to analyze calls and the course of emergency ambulance interventions to patients at their workplace. MATERIAL AND METHODS: The study was conducted based on a retrospective analysis of data contained in the medical records of the ambulance service from central Poland from 2015-2018. From all interventions (n = 155,993), 1601 calls to work were selected, and the urgency code, time of day and year, patients' sex, general condition, as well as diagnoses according to the International Classification of Diseases-ICD-10 and the method of ending the call were considered. RESULTS: The mean age of patients in the study group was 42.4 years (SD ± 13.5). The majority were men (n = 918; 57.3%). The number of calls increased in the autumn (n = 457; 28.5%) and in the morning (n = 609; 38.0%). The main reasons for the intervention were illnesses (ICD-10 group: R-'symptoms') and injuries (ICD-10 group: S, T-'injuries'). Calls at workplaces most often ended with the patient being transported to the hospital (78.8%), and least often with his death (0.8%). CONCLUSIONS: The patient profile in the workplace indicates middle-aged men who fall ill in the fall, requiring transport to the hospital and further diagnostics.

The Activity of N-acetyl-ß-hexosaminidase in the Blood, Urine, Cerebrospinal Fluid and Vitreous Humor Died People Due to Alcohol Intoxication.

BACKGROUND: The article aimed to assess the activity of the hexosaminidase (HEX) and its HEX A and HEX B isoenzymes in persons who suddenly died due to ethanol poisoning and explain the cause of their death. METHODS: The research involved two groups of the deceased group A-22 people (20 males, 2 females; the average age 46 years) who died due to alcohol intoxication (with the blood alcohol content of 4‱ and above in all biological materials at the time of death-blood, urine, cerebrospinal fluid, and vitreous humor), and group B-30 people (22 males, 8 females; the average age 54 years), who died suddenly due to other reasons than alcohol. RESULTS: The highest activity of the HEX was found in the serum of A and B groups. A significantly lower activity of HEX, HEX A, and HEX B was observed in the urine of group A in comparison to the sober decedents. CONCLUSION: The lower activity of HEX and its isoenzymes in the dead's urine due to ethanol poisoning may suggest its usefulness as a potential marker of harmful alcohol drinking. Damage done to the kidneys by ethanol poisoning may be one of the possible mechanisms leading to death. Kidneys may be damaged intravitally via the inflammatory agent. Thus, it is necessary to conduct further research to evaluate the diagnostic usefulness of exoglycosidases while determining the death mechanisms of people who lost their lives due to ethanol poisoning.

Relation of plasma carnitine and aminotransferases to alcohol dose and time of dependence.

BACKGROUND: Serum aspartate, alanine aminotransferases (AST, ALT), and plasma carnitine are all indirect biomarkers of alcohol abuse. Carnitine transfers long-chain fatty acids from cytoplasm to mitochondria for ß-oxidation. The aim of the study was to determine the relationship between daily alcohol intake, time of alcohol dependence, plasma carnitine, and serum aminotransferases. PATIENTS: We studied 26 men who were addicted for 2-30 years, consuming ethanol from 75 to 700 g/day (alcoholic group), as well as 17 healthy men (control group). RESULTS: In alcoholics, compared to the controls, we found: a significant increase in serum: AST (p = 0.0014), ALT (p = 0.0071), AST/ALT ratio (p < 0.000); significantly lower plasma free carnitine (FC) (p = 0.0316) and total carnitine (TC) (p = 0.0349); and a significant negative correlation between FC (r = -0.6200; R2 = 0.3844; p = 0.0007), TC (r = -0.4365; R2 = 0.1905; p = 0.0258), and time of alcohol dependence, suggesting carnitine as an indirect marker of alcohol abuse. We did not find any significant correlation between FC, TC, and levels of alcohol or aminotransferase activity. CONCLUSION: In the alcoholic group, there was an increase in serum activity of AST, ALT, and AST/ALT ratio that confirms liver injury. In addition, we found low plasma FC and TC, which may indicate damage to mitochondrial ß-oxidation caused by alcohol metabolites. The significantly higher plasma FC and TC in patients consuming the most, compared to patients consuming smaller doses of alcohol, may be caused by a lower carnitine demand of injured liver cells, decreased urinary carnitine excretion by impaired renal tubules, and leakage of carnitine into the blood from damaged muscles by the higher quantities of alcohol. The negative correlation between carnitine concentration and time of alcohol dependence may suggest the potential use of carnitine for treatment of alcohol abuse.

Serotonin transporter gene linked polymorphism (5-HTTLPR) determines progredience of alcohol dependence in Belarusian young males.

PURPOSE: Allelic duality and functional impact of degenerate repeat at 5'- flanking promoter region in SLC6A4 gene of the serotonin transporter (5-HTTLPR), have been in the focus of investigations over the years. Various outcomes regarding an association of its polymorphism with risks of alcohol dependence syndrome (ADS) were presented. Such studies have not been conducted in the Eastern European population e.g. Belarus. We therefore checked: the association of 5-HTTLPR polymorphism with ADS, and functional impact of the polymorphism on progredience of ADS in Belarusian population. MATERIAL AND METHODS: The study involved 499 Belarusian males: 377 subjects with ADS (AG), and a control group (CG) with 122 subjects without alcohol-related problems. The ADS group was further divided into two groups of individuals with rapid (AG (R)) and delayed (AG (D)) progression of ADS. Clinical diagnosis was carried-out using ICD-10 criteria, Belarusian Addiction Severity Index, "B-ASI" and Alcohol-Use-Disorders-Identification-Test (AUDIT). PCR-RFLP analysis was performed. RESULTS: There were no significant differences in the distribution of frequencies of either the 5-HTTLPR genotype or the short and long allele among AG and CG. However, the ADS 5-HTTLPR genotype and allele distribution frequencies differ significantly by the variation in progression of ADS. CONCLUSIONS: There is no significant association between polymorphism of serotonin transporter gene and risk of ADS. However, the polymorphism significantly determines progredience of ASD in subjects with pathological patterns of alcohol consumption. Findings from this study carry preliminary significance as a facility to effective alcohol addiction treatment, rehabilitation and preventive services in the Eastern Europe.

Long-term changes of salivary exoglycosidases and their applicability as chronic alcohol-drinking and dependence markers.

OBJECTIVES: Investigation of long-term dynamic changes of salivary activity/output of exoglycosidases, deglycosylation processes and their applicability as alcohol markers. METHODS: Exoglycosidase (α-fucosidase (FUC), ß-galactosidase (GAL), ß-glucuronidase (GLU), ß-hexosaminidase (HEX, HEX A and HEX B isoenzymes) and α-mannosidase (MAN)) activities were measured in the saliva of healthy social drinking controls (C), alcohol-dependent non-smokers (ANS) and alcohol-dependent smokers (AS) at the 1st, 15th, 30th and 50th day of abstinence after chronic alcohol drinking. RESULTS: The activity of exoglycosidases was 2-3-fold (MAN), 2-6 fold (FUC), 8-25-fold (HEX A) and 19-40-fold (GLU) higher in the ANS and AS groups than in controls, and had good/excellent sensitivity, specificity and accuracy. The higher outputs of exoglycosidases were in the AS and ANS groups than in controls at the 1st day (GLU, HEX A) and at the 50th day (GLU, FUC, MAN) of abstinence. We found numerous correlations between alcohol-drinking days with GLU and HEX A, alcohol amounts with HEX A and duration of alcohol dependence with FUC and MAN activity/output. CONCLUSIONS: Salivary exoglycosidases/deglycosylation processes were still very high up to 50 days after the end of alcohol consumption. We found markers of chronic alcohol consumption (HEX A), alcohol dependence (FUC and MAN) and chronic alcohol consumption and dependence (GLU).

Morphological changes of the brain in mood disorders. / Zmiany morfologiczne mózgu w zaburzeniach nastroju.

Brain morphological changes in affective disorders occur mainly in the fronto-limbic cortex, hippocampus and amygdala - the structures regulating emotional and cognitive functioning, as well as development of somatic symptoms in the course of disorders. The largest number of reports of structural changes in the cerebral cortex include the dorsolateral prefrontal cortex, the orbitofrontal cortex and the anterior cingulate cortex. The results of neuroimaging and sectional studies reveal changes in the volume of structures involved in the creation of neuronal circuits that affect development of mood disorders. Microscopic studies show changes in cell count, density, and morphology in these areas. Some of those changes are observed only in certain layers of the cerebral cortex. A valuable addition to this data are histochemical studies of neuronal survival markers, proinflammatory cytokines, trophic factors, and markers specific for particular cellular structures. The role of monoaminergic, GABA-ergic and glutamatergic neurotransmission is confirmed by the studies on concentration of neurotransmitters, their receptors and transporters. Some of the results correlate quantitatively with the type and severity of symptoms, duration of the disorder, as well as pharmacotherapy and nonpharmacological treatment.

Optimization of the method for α-l-fucosidase, ß-d-galactosidase and ß-d-glucuronidase determination in serum from hemolyzed blood.

PURPOSE: Adaptation of the colorimetric method for the determination of ß-d-galactosidase, ß-d-glucuronidase and α-l-fucosidase activities in serums from hemolyzed blood, the material currently being discarded. MATERIALS AND METHODS: The materials included serums from hemolyzed and non-hemolyzed blood, obtained from 26 healthy volunteers. The adaptation of the method involved precipitation of the proteins with trichloroacetic acid after incubating serums with substrates, but before determining the products of enzymatic reactions. RESULTS: In serums from hemolyzed and non-hemolyzed blood of the same persons, we found high correlations among the results obtained using hemolyzed blood (with adapted) and non-hemolyzed blood (with non-adapted) methods. CONCLUSION: We are able to determine the ß-d-galactosidase, ß-d-glucuronidase and α-l-fucosidase activities in serums from hemolyzed blood (with adapted) and non-hemolyzed blood (with non-adapted) methods, with the same accuracy and precision.

Serum Exoglycosidases in Children and Adolescents With Harmful Alcohol Use.

OBJECTIVE: There is a lack of accurate alcohol-use biomarkers in children/adolescents due to a short drinking duration/rapid normalization of elevated markers. We checked if lysosomal exoglycosidases, elevated earlier in binge-drinking young adults, can be applicable in children/adolescents as markers of harmful alcohol use. METHODS: The serum activities (pKat/mL) of α-fucosidase (FUC), ß-galactosidase (GAL), ß-glucuronidase (GLU), ß-hexosaminidase (HEX; its HEX A and HEX B isoenzymes), and α-mannosidase (MAN) were determined in 20 healthy controls (C) and 25 children/adolescents with harmful alcohol use (intoxicated by alcohol at hospital admission -AI1 and on the next day -AI2). RESULTS: The serum HEX A and alanine aminotransferase (ALT) activity was significantly higher in the AI1 group than in the control. The activities of FUC, GAL, GLU, HEX B, and MAN were lower in the AI group. We found fair and poor accuracy, respectively, for increased enzymes HEX A and ALT. We found fair accuracy for decreased HEX B (AI1) and MAN (AI1), good accuracy for GLU (AI2), FUC (AI2), GAL (AI1, AI2), MAN (AI2), and excellent for FUC (AI1). Correlations were found: ALT with C-reactive protein (CRP), HEX A with white blood cell (WBC) count, blood alcohol concentration with FUC, MAN and HEX B, and WBC with FUC. CONCLUSIONS: Decreased FUC, GLU, GAL, MAN values, and especially FUC (AI1) have the potential to be markers of harmful alcohol use in children/adolescents. The raised activity of HEX A and ALT points to the need for further research to check another inflammatory agent as potential alcohol marker in children and adolescents. Samples need to be collected before intravenous fluid therapy.

[Importance of dental care to maintain oral health of children and youth with type 1 diabetes]. / Znaczenie opieki stomatologicznej w utrzymaniu zdrowia jamy ustnej u dzieci i mlodziezy z cukrzyca typu 1.

BACKGROUND: Dental care for children and youth with type 1 diabetes should rely on reliable examination of the oral cavity, early treatment of dental caries and maintenance of the treatment results. This can be achieved through regular control visits consistent with the standards, and also through following the recommendations for prevention of dental caries and periodontal disease. The aim of the study was to investigate whether dental care allows to preserve good oral health of children and youth with type 1 diabetes. MATERIAL AND METHODS: The study included 60 patients with type 1 diabetes, aged 7-17 years, and 30 healthy children and youth within the same age range. There were evaluated intensity of caries, the effectiveness of conservative treatment, periodontal health and oral hygiene. RESULTS: The results of examinations showed significantly lower caries prevalence and better periodontal health in the children and youth with type 1 diabetes. The effectiveness of conservative treatment was significantly higher among patients with mixed dentition. There was no significant difference in oral hygiene between the compared groups. CONCLUSIONS: Diabetes is a risk factor for oral diseases, so children and youth with type 1 diabetes should be provided with special preventive care and curative measures. The main goal of the insulin-dependent diabetes care program is to early classify them to highrisk groups to improve general oral health and thus improve the quality of life. Proper dental care for children and yuoth with type 1 diabetes is a condition to maintain oral health. Med Pr 2018;69(1):37-44.

Salivary immune proteins monitoring can help detection of binge and chronic alcohol drinkers: Preliminary findings.

BACKGROUND: We compared effects of binge and chronic alcohol drinking on oral health and salivary immunity proteins. METHODS: The study involved males: 13 healthy social-drinking (C), 10 alcohol-dependent after chronic alcohol-intoxication (A), and 8 binge-drinkers after a single binge-drinking session (B). We compared periodontal/dental state and salivary immune proteins (lactoferrin -Lf, lysozyme -Lz, oral peroxidase -OPO, immunoglobulin A -IgA) in all groups. RESULTS: Group A had worse dental and periodontal states than group C and B. Group B had a lower OPO activity and Lz concentration, and a higher IgA concentration in comparison to group C. Group A had a higher OPO activity than group C. Group B had a lower Lz and a higher LF and IgA outputs than C. Group A had a lower IgA output and a strong tendency of Lf and Lz outputs to be lower than in group C. Positive correlations were found between alcohol amounts and OPO and Lf output in group A, with no such correlations in group B. Only IgA concentration in group B and OPO activity in group A have potential to be markers that help to differentiate binge from chronic alcohol drinking, and OPO activity had better accuracy than IgA. CONCLUSION: Binge alcohol consumption resulted in specific disturbances in salivary innate immunity (Lz), whereas chronic drinking led to disturbances in both adaptive and innate immunity (IgA, Lz and Lf). There is potential applicability of raised salivary IgA concentration and especially OPO activity in binge and chronic drinking detection and differential-diagnosis.

Unstimulated salivary flow, pH, proteins and oral health in patients with Juvenile Idiopathic Arthritis.

BACKGROUND: There have been inconsistent conclusions regarding salivary abnormalities and their effect on oral health of Juvenile Idiopathic Arthritis (JIA) patients. The purpose of the study was to evaluate the flow rate and selected biochemical parameters of unstimulated whole saliva in correlation to oral health in JIA children. METHODS: Thirty-four JIA patients and 34 age- and sex-matched controls not affected by JIA (C) were divided into two groups: with mixed and permanent dentition. DMFT/dmft, gingival and simplified oral hygiene indices were evaluated. Salivary flow rate, pH, lysozyme, lactoferrin, salivary protein concentrations and peroxidase activity were assessed. RESULTS: The salivary flow rate was significantly lower in the total JIA group (0.41 ml/min) as compared with the C (0.51 ml/min) and in the permanent dentition of JIA children (0.43 ml/min) as compared with the C (0.61 ml/min). A significantly lower pH was observed in total (6.74), mixed (6.7) and permanent (6.76) dentition of JIA groups in comparison to the C (7.25, 7.21, 7.28 respectively). The specific activity of peroxidase was significantly higher in JIA patients (total 112.72 IU/l, mixed dentition 112.98 IU/l, permanent dentition 112.5 IU/l) than in the C group (total 70.03 IU/l, mixed dentition 71.83 IU/l, permanent dentition 68.61 IU/l). The lysozyme concentration in JIA patients (total and permanent dentition groups) was significantly higher than in the C group. There were no significant differences in lactoferrin and salivary protein concentrations. There were no statistically significant differences in oral status between JIA patients and C, respectively: DMFT = 5.71, dmft = 3.73, OHI-S = 0.95, GI = 0.25 and DMFT 5.71, dmft = 3.73, OHI-S = 0.85, GI = 0.24. The specific activity of peroxidase in the unstimulated whole saliva was inversely correlated with the GI index, whereas the salivary lysozyme concentration was inversely correlated with the dmft index in JIA patients. CONCLUSION: In the course of JIA occur a reduction of the resting salivary flow rate and a decrease of saliva pH. In spite of this, no differences in the clinical oral status between the JIA children population and the control group were found. The mobilisation of salivary peroxidase and lysozyme contributes to the maintenance of healthy oral tissues.

Prevention of pancreatic cancer.

Pancreatic ductal adenocarcinoma (PDA) accounts for 95% of all pancreatic cancers. About 230,000 PDA cases are diagnosed worldwide each year. PDA has the lowest five-year survival rate as compared to others cancers. PDA in Poland is the fifth leading cause of death after lung, stomach, colon and breast cancer. In our paper we have analysed the newest epidemiological research, some of it controversial, to establish the best practical solution for pancreatic cancer prevention in the healthy population as well as treatment for patients already diagnosed with pancreatic cancer. We found that PDA occurs quite frequently but is usually diagnosed too late, at its advanced stage. Screening for PDA is not very well defined except in subgroups of high-risk individuals with genetic disorders or with chronic pancreatitis. We present convincing, probable, and suggestive risk factors associated with pancreatic cancer, many of which are modifiable and should be introduced and implemented in our society.

[Juvenile idiopathic arthritis and oral health]. / Mlodziencze idiopatyczne zapalenie stawów a stan jamy ustnej.

Juvenile idiopathic arthritis (JIA) is the most common autoimmune inflammatory disease of connective tissue in children. It is characterized by progressive joint destruction which causes preserved changes in the musculoskeletal system. The literature describes fully clinical symptoms and radiological images in different subtypes of JIA. However, there is still a limited number of studies reporting on the medical condition of the oral cavity of ill children. JIA can affect hard and soft tissues of the oral cavity by: the general condition of the child's health, arthritis of the upper limbs, as the result of the pharmacotherapy, changes in secretion and composition of saliva, inflammation of the temporomandibular joint and facial deformity. The study summarizes the available literature on the condition of the teeth and periodontal and oral hygiene in the course of JIA. The presence of diverse factors that modify the oral cavity, such as facial growth, functioning of salivary glands, or the supervision and care provided by adults, prevents clear identification if JIA leads to severe dental caries and periodontal disease. Despite conflicting results in studies concerning the clinical oral status, individuals with JIA require special attention regarding disease prevention and maintenance of oral health.

Determination of N-acetyl-ß-hexosaminidase in serum from hemolyzed blood.

BACKGROUND: Determination of lysosomal N-acetyl-ß-hexosaminidase (HEX) in serum from hemolyzed blood, creates serious analytical problems, because hemoglobin absorbs light at a similar wavelength like 4-nitrophenol, which is released from artificial substrate. OBJECTIVE: The objective of the work was to adapt a manual method to allow analysis of HEX in hemolyzed samples. METHODS: Serums without and with hemolysis were incubated with 4-nitrophenol-N-acetylglucosamine as a substrate. Released 4-nitrophenol was determined colorimetrically. After the incubation of the serum from hemolyzed blood with substrate, hemoglobin was precipitated with trichloroacetic acid (TCA) before 4-nitrophenol determination. RESULTS: The mean concentration of HEX activity in non-hemolyzed and hemolyzed blood of the same patients, determined with non-modified and modified methods had no significant differences, and they are: 243.12±119.76 and 233.99±108.76pkat/mL, respectively. A coefficient of correlation between non-modified and modified methods equals the 0.98. For HEX determination with the modified method in serum from hemolyzed blood, optimal reaction time was 60min, pH of reaction mixture was 4.7, and Km was 0.11mMm. CONCLUSION: HEX determinations in the same serums from non-hemolyzed blood by the non-modified method and hemolyzed blood with the modified method, gave similar results with a 0.98 coefficient of correlation. The modified method is appropriate for HEX determination in serum from hemolyzed blood.

The strategy of training staff for a new type of helicopter as an element of raising the security level of flight operations.

In 2008, the Polish Medical Air Rescue started replacing its fleet with modern EC135 machines. To ensure the maximum possible safety of the missions performed both in the period of implementing the change and later on, the management prepared a strategy of training its crews to use the new type of helicopter. The analysis of incidents that occurred during 2006-2009 showed that both the human and the technical factors must be carefully considered. Moreover, a risk analysis was conducted to reduce the risk both during general crew training and in the course of particular flight operations. A four-stage strategy of training pilots and crew members was worked out by weighing up all the risks. The analysis of data from 2010 to 2013 confirmed that the risk connected with flying and with all the activities involved in direct support aircraft operations is under control and lowered to an acceptable level.

Serum ß-glucuronidase as a potential colon cancer marker: a preliminary study.

AIM: Colorectal cancer is characterized by high morbidity and mortality in developed countries. The lack of low-cost, easy-to-use screening diagnostic methods is one of the causes of late diagnosis of colorectal cancer. Beta-glucuronidase (GLU) is a lysosomal exoglycosidase involved in degradation of glycosaminoglycans of the cell membranes and extracellular matrix of normal and cancerous colon tissues. The aim of our research was to evaluate the activity of GLU in the serum of colorectal cancer and estimate its potential value in the diagnosis of colorectal cancer. MATERIAL AND METHODS: Blood samples were collected from 21 patients with colorectal adenocarcinoma and 17 healthy subjects. GLU activity was determined by the colorimetric method of Marciniak et al. by measuring the amount of p-nitrophenol released from 4-nitrophenyl-beta-D-glucuronide, at λ = 405 nm. RESULTS: We found significantly greater activity of GLU (p<0.0001) in the serum of patients with colorectal cancer, as compared to the healthy subjects. The serum GLU activity significantly differentiates patients with colorectal cancer from healthy individuals. CONCLUSIONS: Serum GLU activity has diagnostic value and may be used in the diagnosis of colon adenocarcinoma.