Variables Determining Higher Home Care Effectiveness in Patients with Chronic Cardiovascular Disease.

The aim of this cross-sectional study was to analyze the variables that influence the effectiveness of home care in patients with chronic cardiovascular disease and their informal caregivers. The study was conducted in 193 patients and their 161 informal caregivers. The study used the WHOQOL-BREF Quality of Life Questionnaire, the health behavior inventory questionnaire (HBI), the Camberwell assessment of need short appraisal schedule (CANSAS) and the hospital anxiety and depression scale-modified (HADS-M) version. Spearman's rank correlation coefficient test and logistic regression were used for analyses. Analysis of patients revealed an association between home care effectiveness and the following variables (OR per unit): age (OR = 0.98, 95% CI: 0.95-0.99), educational level (OR = 1.45, 95% CI: 1.05-2.02), financial status (OR = 0.43, 95% CI: 0.21-0.83), medication irregularity (OR = 0.25, 95% CI: 0.07-0.72), presence of comorbidities (OR = 6.18, 95% CI: 1.83-23.78), health care services provided by a nurse (OR = 1.25, 95% CI: 1.03-1.64), and number of visits to a cardiology clinic (OR = 1.25, 95% CI: 1.02-1.59). There was no association between care effectiveness and sex (p = 0.28), place of residence (p = 0.757), duration of cardiovascular disease (p = 0.718), number of home visits (p = 0.154), nursing interventions (p = 0.16), and adherence to lifestyle change recommendations (p = 0.539) or proper dietary habits (p = 0.355). A greater chance of improved health care effectiveness was found in patients whose caregivers reported higher social (OR = 1.24, 95% CI: 1.09-1.44), psychological (OR = 1.68, 95% CI: 1.25-2.37), and physical (OR = 1.24, 95% CI: 1.05-1.49) quality of life. Patients with cardiovascular disease who were characterized by lower educational attainment, poorer financial status, fewer visits to cardiology clinics, lower utilization of medical services, poorer self-perception of mental and physical well-being, recent onset of disease symptoms, and irregular use of medications, were much more likely to have poorer health care effectiveness. Patients with cardiovascular disease and their caregivers can be well supported at home as long as the care model is tailored to the specific needs. This includes family care coordination in the health care team, home care, and general practice support.

The Analysis of the Relationship between the Quality of Life Level and Expectations of Patients with Cardiovascular Diseases under the Home Care of Primary Care Nurses.

The World Health Organization defines quality of life as a person's perception of his or her life situation in relation to the culture and value system in which he or she lives, in relation to and with respect to his or her functioning assumptions, expectations, and standards set by environmental conditions. Meeting the expectations of patients with CVD is one of the factors that positively influences their health status and leads to better diagnostic and treatment outcomes. The aim of this study was to answer three main questions related to patients with chronic cardiovascular disease: (1) What is their quality of life? (2) Are patients' expectations about the quality of care provided by primary health care physicians/nurses met (and at what level)? (3) Is there a correlation between patients' quality of life and their expectations of primary health care physicians/nurses? The study involved 193 Polish CVD patients who were cared for at home by a family nurse practitioner working in primary health care facilities. Data were collected from March 2016 to January 2017. The WHOQOL-BREF Quality of Life Questionnaire and the Author Interview Questionnaire were used for the study. Data analysis was based on the Spearman correlation coefficient test. There was a statistically significant association between patients' expectations of the physician regarding information about the course of the disease and quality of life in the following domains: environmental r = 0.20, p = 0.006, psychological: r = 0.18, p = 0.015, physical: r = 0.18, p = 0.013, and social: r = 0.16, p = 0.025. Patients who did not expect the nurse to be courteous, understanding, or interested were found to have higher quality of life scores in psychological (r = -0.17, p = 0.023) and physical (r = -0.15, p = 0.044) domains. There was a statistically significant relationship between expectations of care from nurses regarding intimacy during care activities and the level of satisfaction with one's own health (r = -0.15, p = 0.038) and quality of life (r = -0.14, p = 0.045), as well as quality of life in the domains of physical (r = 0.21, p = 0.004), social (r = 0.19, p = 0.010), and psychological (r = 0.16, p = 0.024). There is a need to define the expectations of patients with chronic cardiovascular disease in primary care, as lack of expectations of a physician/nurse continues to be associated with lower quality of life in all domains.

An Association between Diet and MC4R Genetic Polymorphism, in Relation to Obesity and Metabolic Parameters-A Cross Sectional Population-Based Study.

The melanocortin-4 receptor (MC4R) gene harbours one of the strongest susceptibility loci for obesity and obesity-related metabolic consequences. We analysed whether dietary factors may attenuate the associations between MC4R genotypes and obesity and metabolic parameters. In 819 participants genotyped for common MC4R polymorphisms (rs17782313, rs12970134, rs633265, and rs135034), the anthropometric measurements, body fat content and distribution (visceral and subcutaneous adipose tissue, VAT and SAT, respectively), and blood glucose, insulin, total-, LDL-, HDL-cholesterol, triglycerides concentrations, and daily macronutrient intake were assessed. ANOVA or Kruskal-Wallis tests were used, and multivariate linear regression models were developed. We observed that the CC genotype carriers (rs17782313) presented higher VAT, VAT/SAT ratio, fasting blood glucose and triglyceride concentrations when they were stratified to the upper quantiles of protein intake. An increase in energy derived from proteins was associated with higher BMI (Est. 5.74, R2 = 0.12), body fat content (Est. 8.44, R2 = 0.82), VAT (Est. 32.59, R2 = 0.06), and VAT/SAT ratio (Est. 0.96, R2 = 0.05). The AA genotype carriers (rs12970134) presented higher BMI, body fat, SAT and VAT, fasting blood glucose, triglycerides and total cholesterol concentrations. An increase in energy derived from proteins by AA carriers was associated with higher VAT (Est.19.95, R2 = 0.06) and VAT/SAT ratio (Est. 0.64, R2 = 0.05). Our findings suggest that associations of the common MC4R SNPs with obesity and its metabolic complications may be dependent on the daily dietary intake, which may open new areas for developing personalised diets for preventing and treating obesity and obesity-related comorbidities.

Dietary Macronutrient Intake May Influence the Effects of TCF7L2 rs7901695 Genetic Variants on Glucose Homeostasis and Obesity-Related Parameters: A Cross-Sectional Population-Based Study.

Transcription factor-7-like 2 (TCF7L2) is one of the most important susceptibility genes for type 2 diabetes mellitus (T2DM). The aim of our cross-sectional population-based study was to analyze whether daily macronutrient intake may influence the effects of the TCF7L2 rs7901695 genotype on glucose homeostasis and obesity-related parameters. We recruited 810 participants (47.5% men and 52.5% women), 18-79 years old (mean age, 42.1 (±14.5) years), who were genotyped for the common TCF7L2 rs7901695 single-nucleotide polymorphism (SNP), and anthropometric measurements, body composition, body fat distribution (visceral (VAT) and subcutaneous adipose tissue (SAT) content), blood glucose and insulin concentrations after fasting and during OGTTs, and HbA1c were assessed. The VAT/SAT ratio, HOMA-IR (homeostatic model assessment of insulin resistance), HOMA-B (homeostatic model assessment of ß-cell function), and CIR30 (corrected insulin response) were calculated. The daily macronutrient intake was evaluated based on 3-day food-intake diaries. Daily physical activity was evaluated based on a validated questionnaire. We performed ANOVA or Kruskal-Wallis tests, and multivariate linear regression models were created to evaluate the effects of dietary macronutrient intake on glucose homeostasis and obesity-related parameters in carriers of the investigated genotypes. This study was registered at ClinicalTrials.gov as NCT03792685. The TT-genotype carriers stratified to the upper protein intake quantiles presented higher HbA1c levels than the CT- and CC-genotype participants in the same quantiles (p = 0.038 and p = 0.022, respectively). Moreover, we observed higher HOMA-IR (p = 0.014), as well as significantly higher blood glucose and insulin concentrations, during the OGTTs for those in the upper quantiles, when compared to subjects from the lower quantiles of protein intake, while the CC-genotype carriers presented significantly lower HbA1c (p = 0.033) and significantly higher CIR30 (p = 0.03). The linear regression models revealed that an increase in energy derived from proteins in TT carriers was associated with higher HbA1c levels (ß = 0.37 (95% CI: 0.01-0.74, p = 0.05)), although, in general, carrying the TT genotype, but without considering protein intake, showed an opposite tendency-to lower HbA1c levels (ß = -0.22 (95% CI: 0.47 to -0.01, p = 0.05). Among the subjects stratified to the lower quantile of carbohydrate intake, the TT-genotype individuals presented higher HbA1c (p = 0.041), and the CC-genotype subjects presented higher VAT (p = 0.033), lower SAT (p = 0.033), and higher VAT/SAT ratios (p = 0.034). In both the CC- and TT-genotype carriers, we noted higher VAT (p = 0.012 and p = 0.0006, respectively), lower SAT (p = 0.012 and p = 0.0006, respectively) and higher VAT/SAT ratios (p = 0.016 and p = 0.00062, respectively) when dietary fat provided more than 30% of total daily energy intake, without any differences in total body fat content. Our findings suggest that associations of the common TCF7L2 SNP with glucose homeostasis and obesity-related parameters may be dependent on daily macronutrient intake, which warrants further investigations in a larger population, as well as interventional studies.

Factors Differentiating Rural and Urban Population in Determining Anxiety and Depression in Patients with Chronic Cardiovascular Disease: A Pilot Study.

The aim of this cross-sectional study was to analyze selected variables differentiating rural from urban populations, as well as identify potentially increased levels of depression and anxiety in patients with chronic cardiovascular disease. The study was carried out in 193 patients. The study used the Camberwell Assessment of Need Short Appraisal Schedule (CANSAS), the Health Behavior Inventory Questionnaire (HBI), the WHOQOL-BREF Quality of Life Questionnaire, and the Hospital Anxiety and Depression Scale-Modified Version (HADS-M). Spearman's rank correlation coefficient test and logistic regression were used for analyses. In rural patients, we observed a relationship between anxiety and age (1/OR = 1.04; 95% CI: 0.91-0.99), the assessment of satisfied needs (1/OR = 293.86; 95% CI: 0.00001-0.56), and quality of life (QoL) in physical (OR = 1.56; 95% CI: 1.11-2.33), social (1/OR = 1.53; 95% CI: 0.04-0.94), and environmental domains (OR = 1.67; 95% CI: 1.06-3.00), as well as between depression and QoL in physical (1/OR = 1.39; 95% CI: 0.50-0.97) and psychological (OR = 1.37; 95% CI: 1.01-1.93) domains. In city patients, we observed a relationship between the drug and Qol in the physical (1/OR = 1.25; 95% CI: 0.62-0.98) and psychological (OR = 1.49; 95% CI: 1.13) domains. Younger patients living in a rural area with a lower assessment of met needs, a higher level of QoL in physical and environmental domains, and a lower social domain, as well as patients living in a city with a lower QoL in the physical domain and a higher psychological domain, have a greater chance of developing anxiety and depressive disorders.

Needs, Aggravation, and Degree of Burnout in Informal Caregivers of Patients with Chronic Cardiovascular Disease.

This study aimed to answer three main questions with respect to home caregivers for people with cardiovascular disease: (1) Are the needs of home caregivers being met (and at what level)?; (2) what is the level of emotional exhaustion, depersonalization, and personal accomplishment of home caregivers?; (3) what sociodemographic variables of home caregivers are related to unmet needs and level of emotional exhaustion, depersonalization, and personal accomplishment? The study used the Camberwell Modified Needs Assessment questionnaire and the Maslach Burnout Inventory questionnaire. This study reports on 161 informal home caregivers of patients with cardiovascular disease. We found that younger caregivers were less likely to report unmet needs (p = 0.011), and showed lower rates of burnout on depersonalization and emotional exhaustion. In addition, caregivers who worked more often reported higher levels of met needs (p = 0.022), and showed lower rates of burnout on depersonalization (p = 0.005) and emotional exhaustion (p = 0.018). Subjects residing in urban areas were more likely to report unmet needs (p = 0.007), and showed higher rates of burnout on emotional exhaustion (p = 0.006). Older caregivers who are unemployed and reside in cities should be offered programs to determine their unmet needs and to receive support.

[Acute poisoning with e-cigarette liquid ­ case report].

Spreading e-cigarettes popularity comes from relief, the products are safe. They don't contain carcinogenic substances, that are present in tobacco smoke. But nicotine present in e-liquid is a very toxic alkaloid, highly addictive. A case of acute, oral intoxication with e-liquid was described. A patient, 42-years old woman, e-cigarettes addicted, health thus far, by accident drunk a swig of e-liquid containing nicotine at concentration 6 mg/ml. At admission to Toxicology Department she was conscious, with symptoms: dizziness, flushed cheeks, dry skin, dry conjunctivas, medium-wide pupils, nervous twitch, tachycardia, elevated blood pressure. Concentration of cotinine ­ nicotine metabolite, in serum and urine were respectively 2077 and 10236 ng/ml. Applied treatment was: infusive liquids, intravenous alkalization, administration of electrolytes and propranolol. Gradually improvement was reached and on the third day of hospitalization, after psychiatric consultation she was deinstitutionalized in good medical condition to continue treatment in Neurology Clinic. E-fluid intoxications are rare, poisoning course depends on nicotine dose, way of absorption, patient's health state and age.

Exposure to environmental tobacco smoke and respiratory tract infections in pre-school children - a cross-sectional study in Poland.

INTRODUCTION AND OBJECTIVE: Knowledge of the harmful influence of environmental tobacco smoke (ETS) has a positive impact on changing social behaviours worldwide. In many homes smoking is totally prohibited; in some others, partial limitations of tobacco consumption have been introduced. OBJECTIVE: To study the correlation between the adopted rules of tobacco use in homes of 3-year-olds, and the kind and frequency of acute respiratory system infections within a 6-month period of attending pre-schools. MATERIALS AND METHODS: The study was performed among children attending municipal pre-schools in Bialystok, Poland. The data was collected by anonymous questionnaires completed by the parents of 302 children aged 3 years chosen randomly from 1,200 children attending 51 pre-schools. The exposure of children to tobacco smoke was measured by determining cotinine to creatinine ratio (CCR) in urine. RESULTS: In the 150 families of children who were surveyed, 210 were smokers. Every day, the smokers consisted of fathers (37.3%) and mothers (23.6%). The 3-year-old children were divided into 3 groups according to smoking habits in their homes: 28.5% of the children under examination came from homes where tobacco smoking was forbidden (mean CCR - 15.21 ng/mg, SD=11.86), 26.2% came from homes where tobacco was smoked in separate rooms (mean CCR - 65.75 ng/ml, SD=81.51), 45.4% lived in homes where no rules connected with smoking had been established (mean CCR - 61.75 ng/ml, SD= 70.29). During the analyzed period of 6 months, 85% of the children had at least 1 respiratory tract infection (60% - upper, 16.9% - lower, 16.5% - upper and lower, 7.1% - otitis media). CONCLUSIONS: The majority of the 3-year-old children who had lower respiratory tract infections required antibiotics and hospitalization. Living in a home where no tobacco rules were established may cause an increase of respiratory tract infections.

[Exposure to environmental tobacco smoke in pre-school children--a comparative study]. / Narazenie dzieci w wieku przedszkolnym na dym tytoniowy--badanie porównawcze.

The objective of the work was to compare the socioeconomic situation and the structure of tobacco use in the families of children attending preschools in Bialystok in 2004 and 2012 in terms of 3-year-olds' exposure to environmental tobacco smoke (ETS). The study involved 313 children out of 1,200 3-year-olds attending 51 pre-schools in Bialystok in 2004 (Gr I) and 273 children out of 1,100 attending 49 pre-schools in 2012 (Gr I). Information on environmental conditions and the use of tobacco in the families of the studied 3-year-olds was obtained through anonymous questionnaires filled in by their parents or caregivers. The exposure of children to ETS was evaluated using the questionnaire and by determining the cotinine/creatinine ratio in urine. The children from Gr I had better educated (p<0.001) and wealthier (p=0.005) parents, and better living conditions (p=0.008). In 47.3% of the homes of children from Gr I and 31.1% of homes of children from Gr II there was at least one smoking person (p<0.001). Both in 2004 and in 2012, fathers prevailed among the smokers, but in 2012 their number was significantly lower (p<0.001). As for mothers, 23.6% of them in Gr I and 10.3% in Gr I admitted smoking every day (p<0.001). More children from Gr I than from Gr I lived with smoking grandparents. The declared number of cigarettes smoked a day by the people living with the children was similar in both Groups The Groups did not differ significantly regarding the rules of tobacco smoke applying to the family members and guests (p=0.639). The mean cotinine/ creatinine concentration [ng/mg] in the urine of children from Gr I (60.78) was significantly higher than in those from Gr II (22.75) (p<0.001). According to the survey data, in 2012 fewer three-year-olds were exposed to ETS out of home (p<0.001). The mean cotinine/ creatinine concentrations [ng/mg] depending on the declared exposure to tobacco smoke out of home: no exposure, existing exposure, unknown exposure, were for Gr I and Gr II, respectively: 51.31 vs. 35.67; (p<0.001), 76.10 vs. 38.65; (p=0.002), 76.92 vs. 47.04; (p=0.460). In 2012, as compared to 2004, the number of smokers among young parents decreased, but despite education activities in the community, only 1/4 of homes with children had the "no smoking" rule.

Psychiatric symptomatology and personality in a population of primary care patients.

INTRODUCTION AND OBJECTIVE: Psychiatric disorders (and their high rates of prevalence) in primary care have been widely analyzed, but the problem of underdiagnosis remains unresolved. This becomes increasingly more important in rural health centres in the face of lack of epidemiological data from these centres. The aim of this study is focused on the relationship between general health, psychiatric symptomatology and personality characteristics in the context of an adequate diagnosis. MATERIALS AND METHODS: 518 primary care patients in 6 Polish urban clinical centres were studied using (in order of administration): a sociodemographic questionnaire, the General Health Questionnaire (GHQ-28) and Eysenck Personality Questionnaire (EPQ-R). RESULTS: The investigated sample was representative for urban primary care patients. The findings confirmed a significant association between neuroticism and general health. The strongest relation with current functioning and mental distress of the patients (GHQ general score) was observed in case of symptoms of anxiety and insomnia. The symptoms of depression may be the most difficult to identify (psychiatric symptoms assessed using GHQ sub-scales). CONCLUSIONS: According to the GHQ assumptions and confirmed by the presented study, sub-threshold psychiatric symptomatology affects the functioning of primary care patients and their general health. This correlates with personality factors. Improving adequacy of diagnosis becomes extremely important, as it may often be the only chance for appropriate therapy of mental problems for people living in rural areas due to lower availability of specialistic mental services. Further epidemiological studies concerning rural primary care and prevalence of the spectrum of mental disorders need to be conducted.

Pedometer assessed physical activity of people with metabolic syndrome in Poland.

INTRODUCTION: Metabolic syndrome is a contemporary disease of civilization, an effect of lack of healthy behaviour, a consequence of lifestyle devoid of physical activity, eating poor quality food rich in calories and excessive stress. Apart from a proper diet, physical activity remains an important part of metabolic syndrome management. OBJECTIVE: The main objective of the work was to evaluate the physical activity of an adult population of patients with metabolic syndrome. materials and method. Adults aged 35-70 fulfilling the criteria of metabolic syndrome according to International Diabetes Federation (IDF) were included. New Lifestyles NL-2000 pedometers were used to assess locomotive physical activity during an entire week. RESULTS: In the group of 100 subjects, as many as 61 people (61%) represented low or sedentary activity, while nearly one fourth of the respondents - 23 (32%) represented the negligible activity type. Average weekly physical activity of those in the study was 6,743 steps/day (in 100 individuals) and ranged from 1,781-15,169. A great diversity was found in the study group, since the highest number of steps per day was 23,347 and the lowest - 409. No significant differences in the number of steps on weekdays and at weekends were observed (mean: 6,676/day and 6,913/day, respectively). A statistically significant negative correlation (r = -0.29) was observed between age and physical activity, between the average daily number of steps in the week and Waist Hip Ratio (WHR) (r = 0.201), as well as between the average daily number of steps in the week and Body Mass Index (BMI) (r = 0.226). CONCLUSIONS: The majority of people with metabolic syndrome represent a low or sedentary activity type and decrease of physical activity corresponds to increasing age, BMI and WHR. No significant differences in physical activity are observed between working days and free days (weekends).

[Patterns of drinking alcohol tobacco smoking among 6th year students of the faculty of medicine in Bialstok]. / Wzorce picia alkoholu i palenie tytoniu wsród studentów VI roku Wydzialu Lekarskiego Uniwersytetu Medycznego w Bialymstoku.

INTRODUCTION: Alcohol and tobacco are legal, easily available addictive substances. There are no universal criteria of safe alcohol consumption but some scientific studies have allowed for determination of consumption levels helpful in evaluation of the pattern of drinking and evoking readiness to limit the amount of consumed alcohol. THE AIM: The aim of the work was to evaluate and compare the knowledge of 6th year students of the Faculty of Medicine of the Medical University of Biatystok in the academic years 2011/12 and 2012/13 concerning the effects of alcohol abuse, as well as to determine their drinking patterns and tobacco smoking structure. MATERIALS AND METHODS: The study material was collected by means of anonymous voluntary surveys carried out before classes concerning the issues of addictions within the framework of family medicine subject block. RESULTS: 356 students took part in the study: 226 (63.5%) women and 130 (36.5%) men (p<0.000). 4.86% of the respondents displayed a high level of knowledge on the harmfulness of alcohol abuse; 63.43% had an average level of knowledge and 31.71% - a low one. 51,32% women and 62,3% men drank alcohol in a hazardous way. A relation was found between a low level of knowledge and the amount of alcohol consumed on a typical drinking day (rS=-0.15, p=0.03) as well as between a low level of knowledge and hazardous drinking (rS=-0.13, p=0.03). Among the respondents, 18,58% women and 14,63% men smoked cigarettes regularly. Those who are 6th year students in the academic year 2012/13 usually had started smoking within the first three years of study at the Medical University and drank greater amounts of alcohol on a typical drinking day than students surveyed in the 2011/12 year. A correlation was found between tobacco smoking and a greater frequency of getting drunk occasionally (rS=-0.18, p=0.002) among students of both years. CONCLUSION: Insufficient knowledge on the effects of alcohol abuse and smoking coexist with a higher risk of drinking alcohol.

[Social support versus chosen health status indicators in primary care patients]. / Wsparcie spoleczne a wybrane wskazniki stanu zdrowia pacjentów podstawowej opieki zdrowotnej.

AIM: The purposes of our study were to determine the level of total social support, informational support, instrumental support, appraisal support and emotional support received by patients of primary care as well as factors related to this level with reference to health status and sociodemographic variables. METHOD: The sample for current analysis included 516 patients of primary care clinics in Poland cooperating with medical universities. Questionnaires: STAI (State-Trait Anxiety Inventory), SCL-90 (Symptom Checklist-90), EPQ-R (Eysenck Personality Questionnaire-Revised), GHQ (General Health Questionnaire)and SSS (Social Support Scale)were used in the study. Results from last two questionnaires are presented in the paper. RESULTS: The highest mean levels were obtained for instrumental support, while the lowest levels were observed for emotional support. The highest means were indicated in the GHQ-28-social dysfunction, the lowest-GHQ-severe depression. Statistically significant relation was found between the level of social support and gender. Less subjectively evaluated total social support as well as instrumental and appraisal support were obtained by women. The highest Spearman score was found in the case of total GHQ-28 score, somatic symptoms, anxiety and insomnia, severe depression and total support. Taking into account the ANOVA findings, it was observed that an increasing GHQ score was associated with intensively increasing emotional support, informative support, appraisal support and the most- instrumental support. CONCLUSION: The results display the underestimated role of emotional, informational and appraisal support and the overestimated role of instrumental support in primary care. The consequence may be a more frequent using health care accompanied by low level of patients' satisfaction, severity of social dysfunction disorders, particularly in patients with chronic diseases, who constitute an increasingly large group of primary health care.

Curcumin-containing liposomes stabilized by thin layers of chitosan derivatives.

Stable vesicles for efficient curcumin encapsulation, delivery and controlled release have been obtained by coating of liposomes with thin layer of newly synthesized chitosan derivatives. Three different derivatives of chitosan were obtained and studied: the cationic (by introduction of the stable, quaternary ammonium groups), the hydrophobic (by attachment of N-dodecyl groups) and cationic-hydrophobic one (containing both quaternary ammonium and N-dodecyl groups). Zeta potential measurements confirmed effective coating of liposomes with all these chitosan derivatives. The liposomes coated with cationic-hydrophobic chitosan derivative are the most promising curcumin carriers; they can easily penetrate cell membrane and release curcumin in a controlled manner. Biological studies indicated that such systems are non-toxic for murine fibroblasts (NIH3T3) while toxic toward murine melanoma (B16F10) cell line.

A thermosensitive carrageenan-based polymer: synthesis, characterization and interactions with a cationic surfactant.

Novel polyelectrolytes were obtained by grafting N-isopropylacrylamide (NIPAM) on the ι-carrageenan (CAR) chain. Two polymers with different grafting degrees were synthesized. The polymers were found to show the lower critical solution temperature (LCST) close to that of PNIPAM. The LCST values were dependent on the concentration of salt and cationic surfactant. The interactions of CAR-graft-PNIPAM with a model cationic surfactant-dodecyltrimethyl ammonium chloride (DTAC) in water and 0.15M NaCl were studied. It was found that both ι-carrageenan and CAR-graft-PNIPAM polymers interact with DTAC. The presence of CAR-graft-PNIPAM in the solution of DTAC induces formation of surfactant aggregates at the critical aggregation concentration much lower than the cmc of the surfactant. Cac increased with ionic strength. The values of cac for CAR-graft-PNIPAM - DTAC system and standard free enthalpy changes attributed to the complexation process were determined. The results obtained for CAR-graft-PNIPAM were compared with these for the non-modified ι-carrageenan. The surfactant interactions with non-modified and grafted polymers were found to be different in nature.

Quality of life and acceptance of illness among patients with chronic respiratory diseases.

The purpose of this study was to determine quality of life (QoL) and acceptance of illness in patients with chronic respiratory diseases. The study involved 315 adult patients of the mean age of 63.9±15.7 years. The World Health Organization Quality of Life Instrument Short Form and the Acceptance of Illness Scale were used. The mean score for QoL was 2.0±1.3. The highest scores were obtained in the Social Relationship Domain (13.9±2.7) and the lowest in the Environmental Domain (10.5±2.2). The strongest correlations within QoL domains were noted between Physical and Psychological Domains: r=0.611 (p<0.001), Psychological and Social Domains: r=0.605 (p<0.001). The overall degree of illness acceptance was low (26.0±7.8). The strongest correlations were observed between illness acceptance and Physical: r=0.591 (p<0.001) and Psychological Domains: r=0.450 (p<0.001). We conclude that illness acceptance can be augmented by improving the patient's clinical state and by the provision of psychological support and QoL by improving the Psychological and Environmental Domains.

[Kindergartners' indoor exposition to tobacco smoke and its influence on cotinine concentration in children's urine]. / Narazenie dzieci w wieku przedszkolnym na dym tytoniowy i jego wplyw na stezenie kotyniny w moczu.

The purpose of the research was to study kindergarteners' exposition to environmental tobacco smoke (ETS) in houses. Social and economical factors were checked for the improper behavior of grown-up household. Material for the research were data collected from questionnaires filled by children's parents. 272 three years old children were studied (57.7% boys and 42.3% girls). Cotinine--marker of exposition to ETS was measured in the children's urine. In 32.4% houses at least one resident was a tobacco smoker. The most often it was father (22.3%) or mother (10.6%). Most of them (78.7%) affirmed tobacco smoking out of houses. Tobacco smoking correlated to parents education (mothers--college graduate and fathers--high-school graduate smoked tobacco the most often). Tobacco smoking by the parents correlated to low household income (less than 1000 zl), many house occupants (4-5 persons), small house area (less than 15 m2/person). A part of studied group of children (11%) was exposed to ETS out of house. Mean cotinine concentration in urine of children exposed and unexposed to ETS in house were not significantly different an were respectively: 25.60 and 21.22 ng/mg creatinine. Propagation of right behavior among people smoking tobacco in houses and education of small children parents is important.

Novel polymeric inhibitors of HCoV-NL63.

The human coronavirus NL63 is generally classified as a common cold pathogen, though the infection may also result in severe lower respiratory tract diseases, especially in children, patients with underlying disease, and elderly. It has been previously shown that HCoV-NL63 is also one of the most important causes of croup in children. In the current manuscript we developed a set of polymer-based compounds showing prominent anticoronaviral activity. Polymers have been recently considered as promising alternatives to small molecule inhibitors, due to their intrinsic antimicrobial properties and ability to serve as matrices for antimicrobial compounds. Most of the antimicrobial polymers show antibacterial properties, while those with antiviral activity are much less frequent. A cationically modified chitosan derivative, N-(2-hydroxypropyl)-3-trimethylammonium chitosan chloride (HTCC), and hydrophobically-modified HTCC were shown to be potent inhibitors of HCoV-NL63 replication. Furthermore, both compounds showed prominent activity against murine hepatitis virus, suggesting broader anticoronaviral activity.

Modified polysaccharides as versatile materials in controlled delivery of antidegenerative agents.

The mechanisms and factors causing or influencing degenerative diseases require tailor-made solutions. Natural polysaccharides are among the most versatile building units of the novel drug delivery systems. Their properties can be easily tailored to specific needs because they depend not only on the first-order structure, but also on the molecular weight, the type of end-groups and the conformation of the chain. The review presents the current state-of-art in the field of modifications of natural polysaccharides aiming at improving the delivery of anti-degenerative agents. Derivatization includes introducing of ionic or hydrophobic groups in order to adjust polarity or to obtain amphiphilic material, as well as degradable bonds, spacers and targeting moieties. The influence of the modification on the properties of the carrier, such as its size, surface charge, encapsulation efficiency, drug release profile, and stability in vivo, is discussed. Application of the polysaccharide derivatives to enhance the mucoadhesion and to actively target the drug to its site of action is also shown for a variety of carriers: nano and microparticulate systems, coated liposomes, hollow particles and polymer-drug conjugates.

[Drinking alcohol--a frequent risk behaviour among upper secondary school students]. / Picie alkoholu - czeste zachowanie ryzykowne mlodziezy szkól ponadgimnazjalnych.

INTRODUCTION: Health behaviours are being developed over the whole life span of a human. What is particularly important is the behaviours which are consolidated in childhood and adolescence, because a young person with lower self-control ability is more prone to taking risky actions which can result in immediate and future health consequences. The aim of the work is to analyse alcohol consumption among upper secondary school students and to determine the relation between that behaviour and selected aspects of their lives. MATERIAL AND METHOD: The study material was gathered by means of an anonymous survey carried out among students of the second grade in randomly selected general upper secondary schools in Bialystok. A self-constructed questionnaire entitled "My health" was used in the study. The obtained results were subject to statistical analysis. RESULTS: Most of the respondents (87.1%) have drunk alcohol before and have tried that substance more than two or three times in their lives. The highest number of students started to drink alcohol at the age of fifteen. 87.5% of girls and 86% of boys drank alcohol. Drinking was more common among teenagers living in single-parent families (92.3%) and families without close relationships. The percentage of drinkers was higher in the group of teenagers whose friends accepted drinking alcohol (85.7%). Among those who drank, there was the most percentage of students who smoked cigarettes and took drugs as well. The students who did well at school used alcohol more rarely (70.5%). People under age have easy access to alcohol- 88.5% of the respondents had no problems buying it at shops. CONCLUSIONS: There is a necessity to attract attention to the problem of teenagers drinking alcohol and to take actions aimed at informing them about the risk and harms resulting from such behaviour before they start studying at lower secondary schools.