Worse survival in breast cancer in elderly may not be due to underutilization of medical procedures as observed upon changing healthcare system in Poland.

BACKGROUND: Evidence is emerging that older women may tolerate breast cancer therapies equally well as the young ones, providing that they receive good supportive care. It has also been reported that these patients remain outside the current therapeutic standards. The aim of this observational study was to assess the access of breast cancer patients to medical procedures. METHODS: We retrospectively reviewed a database of breast cancer patients registered in the National Cancer Registry in Poland, searching for the numbers of new cases and deaths in the years 2010-2015. We obtained the numbers and costs of key medical procedures provided for these patients from the National Health Fund in Poland. Breast cancer survival in the years 2010-2015 was estimated based on the mortality/incidence ratio. The t-Student test and Spearman correlation coefficient were used for the analysis of data obtained from both databases. RESULTS: There was no increase in survival throughout the years 2010-2015 in both analysed subpopulations of all breast cancer patients below and over 65 years of age, despite an unprecedented rise in healthcare funding in Poland. We noted 37% lower probability of 5-year survival in patients older than 65 years. The average number of outpatient visits and surgical procedures per person per year were slightly, yet significantly (p < 0.01), higher in younger vs. older patients (3.9 vs. 3.4 and 1.18 vs. 1.02, respectively). Outpatient chemotherapy was more common in older patients (6.0 vs. 5.25 cycles a year per person on average, p < 0.01). There were no significant differences in the average numbers of hospitalisations for chemotherapy, frequencies of radiotherapy and in the use of targeted therapy programmes (calculated per person per year), between younger and older patients. CONCLUSIONS: Older women with breast cancer are treated similarly to younger patients, but have significantly worse chances to survive breast cancer in Poland. A simple increase in healthcare financing will not improve the survival in the elderly with breast cancer without developing funded individualised care and survivorship programmes.

Physical properties and biological interactions of liposomes developed as a drug carrier in the field of regenerative medicine.

Liposomes are used for encapsulation of the active compounds in different therapies, with the increasing frequency. The important areas of clinical applications of liposomes are cancer targeted treatment, antibiotic delivery or regenerative medicine. The liposomes can transfer both hydrophilic and hydrophobic compounds and have the lipid bilayer which imitates the cell membrane. Liposomes additionally may extend half-live period of drugs and protect them against the elimination in different ways, such as phagocytosis, enzymatic cleavage or exclusion by detoxification. The size and charge of liposomes play an important role in drug distribution and absorption into the cell. Limited data is available on the effects of liposomes on stem cells and progenitor cells. In this article, we examined the effect of charged conventional liposomes on growth of mesenchymal and blood stem cells isolated from umbilical cord. The data suggest a likelihood, that positively charged liposomes could impair stem cell growth and metabolism. Different methodological approaches allowed for the selection of negatively charged liposomes for further experiments, as the only type of liposomes which has the lowest cytotoxicity and does not affect hematopoietic cell proliferation.

Evaluation of the Levels and Quality of Microbial Contamination in Medical Emergency Departments in Comparison to Other Workplaces.

Work in Hospital Emergency Departments (HEDs) exposes both the emergency ward staff and patients to infectious and in other way harmful biological agents. The results of this study shows the presence of pathogenic bacteria isolated by three different methods. It revealed 9.8% of pathogens detected by imprint method, 10.5% of pathogens by swabbing method, 17.6% and 22% in HEDs corridors and rooms, respectively, by air sampling method. In control workplaces (offices) pathogenic bacteria reached the level of 6.5% and 14.7% by imprint method and swabbing, respectively. The relatively low level of contamination by bacteria in HEDs may depend on the effectiveness of Standard Protective Precautions in the studied hospitals.

Pollution of mycological surfaces in hospital emergency departments correlates positively with blood NKT CD3(+) 16(+) 56(+) and negatively with CD4(+) cell levels of their staff.

The aim of the present study was the assessment of the putative influence of yeast and filamentous fungi in healthcare and control (office) workplaces (10 of each kind) on immune system competence measured by NK (natural killer), CD4(+), and NKT (natural killer T lymphocyte) cell levels in the blood of the personnel employed at these workplaces. Imprints from floors and walls were collected in winter. The blood was taken in spring the following year, from 40 men, 26 to 53 years old, healthcare workers of hospital emergency departments (HED), who had been working for at least five years in their current positions, and from 36 corresponding controls, working in control offices. Evaluation of blood leukocyte subpopulations was done by flow cytometry. The qualitative analysis of the surface samples revealed a prevalence of strains belonging to Aspergillus spp. and Penicillium spp. genus. There was no statistically significant difference between the level of NKT; however, the percentage of NK cells was lower in the blood of HED workers than in the blood of offices personnel. Spearman analysis revealed the existence of positive correlation (r = 0.4677, p = 0.002) between the total CFU/25 cm(2) obtained by imprinting method from walls and floors of HED and the percentage of NKT (CD3(+)16(+)56(+)) lymphocytes collected from the blood of their personnel, and negative correlation (r = -0. 3688, p = 0.019) between this parameter of fungal pollution and the percentage of CD4(+) lymphocytes in the blood of HED staff. No other correlations were found.

The influence of the workplace-related biological agents on the immune systems of emergency medical personnel.

Emergency medical services workers' (EMSWs) acute exposures to many biological agents are frequent and well recognised in their workplaces, as well as occupational diseases resulting from some of these exposures. At the same time, there is only scant information on the adverse effects of chronic exposure to biological hazard factors on the immune systems of EMSWs. In the Polish legislation system, the Ordinance of the Minister of Health about harmful biological agents in the workplace and ways of protecting workers from exposure to those agents is an implement of Directive 2000/54/EC, which deals thoroughly with those issues in European Union Countries. Emergency medical services workers play an essential role as primary providers of pre-hospital emergency medical care, and they are part of the integral components of disaster response. Traumatic experiences can affect emergency medical staff immune systems negatively, by functioning as a chronic stressor. Conscious use of biological agents in workplaces such as microbial laboratories can be easily controlled and monitored. However, risk assessment is more difficult for workers when they are exposed unintentionally to biological agents. Exposure to bio-aerosols is considered especially harmful. This review summarises available information about biological risk factors for emergency medical services workers, and some information about the influence of these factors on their immune systems.

Negative correlation between mycological surfaces pollution in hospital emergency departments and blood monocytes phagocytosis of healthcare workers.

The aim of the present study was to find a possible relationship between the presence of yeast and filamentous fungi in hospital emergency departments and the activity levels of blood granulocytes and monocytes in emergency personnel. The study of mycological pollution was conducted in winter; the samples were collected from 10 Warsaw hospitals emergency departments (HE D) and in 10 control locations (office spaces) and included air samples and swabbing of floor and walls. The blood for immunological investigation was taken in spring, from 40 men, 26 to 53 years old, healthcare workers of these departments, who have been working for at least 5 years in their current positions, and from 36 corresponding controls, working in control offices. Evaluation of blood leukocyte subpopulations was done by hematological analyzer and cytometry analysis and monocyte and granulocyte phagocytosis by Phagotest. There were no significant differences in the level of mycological contamination between the test and control places. The qualitative analysis of the surfaces and air samples revealed a prevalence of strains belonging to Aspergillus spp. and Penicillium spp. genus. Statistical analysis revealed the existence of negative correlation between the number of phagocytizing blood monocytes and fungi spores content on floor and wall surfaces in hospital emergency departments (r = -0.3282, p < 0.05 and positive correlation between the number of phagocytizing monocytes in the blood of office workers and fungi pollution of control offices (r = 0.4421, p < 0.01).

Feeding mice with Aloe vera gel diminishes L-1 sarcoma-induced early neovascular response and tumor growth.

Aloe vera (Aloe arborescens, aloe barbadensis) is a medicinal plant belonging to the Liliaceae family. Aloe vera gel prepared from the inner part of Aloe leaves is increasingly consumed as a beverage dietary supplement. Some data suggest its tumor growth modulatory properties. The aim of the present study was to evaluate in Balb/c mice the in vivo influence of orally administered Aloe vera drinking gel on the syngeneic L-1 sarcoma tumor growth and its vascularization: early cutaneous neovascular response, tumor-induced angiogenesis (TIA test read after 3 days), and tumor hemoglobin content measured 14 days after L-1 sarcoma cell grafting. Feeding mice for 3 days after tumor cell grafting with 150 µl daily dose of Aloe vera gel significantly diminished the number of newly-formed blood vessels in comparison to the controls. The difference between the groups of control and Aloe-fed mice (150 µl daily dose for 14 days) with respect to the 14 days' tumor volume was on the border of statistical significance. No difference was observed in tumor hemoglobin content.

Oral administration of Aloe vera gel, anti-microbial and anti-inflammatory herbal remedy, stimulates cell-mediated immunity and antibody production in a mouse model.

INTRODUCTION: Aloe vera (L.) Burm. f. (Aloe barbadensis Mill) Liliaceae, succulent plant native to northern Africa, is presently cultivated in many regions of the world. Traditionally, its inner part of parenchyma, which contains aloe gel, was used for the treatment of minor wounds, inflammatory skin disorders, thermal and radiation burns and to alleviate chronic osteoarthritis pain. It also possesses some antimicrobial activity. Now, aloe gel is also increasingly consumed as a dietary supplement. Some data suggest its immunomodulatory properties. THE AIM OF THE STUDY: The aim of the study was to evaluate the influence of orally administered aloe gel on some parameters of cellular and humoral immunity viz. mitogen-induced proliferation of splenic lymphocytes and their chemokinetic activity, and anti-sheep red blood cells (SRBC) antibody production in Balb/c mice. RESULTS: Daily treatment of mice for 14 and 21 days with 50 µl or 150 µl of aloe gel dose resulted in enhanced chemokinetic activity and stronger response of their splenic lymphocytes to mitogen PHA and enhancement of anti-SRBC antibody production.

The effect of anti-inflammatory and antimicrobial herbal remedy PADMA 28 on immunological angiogenesis and granulocytes activity in mice.

UNLABELLED: PADMA 28 is a herbal multicompound remedy that originates from traditional Tibetan medicine and possesses anti-inflammatory, antioxidant, antimicrobial, angioprotecting, and wound healing properties. The aim of the present study was to evaluate the influence of this remedy on immunological angiogenesis and granulocytes metabolic activity in Balb/c mice. Mice were fed daily, for seven days, with 5.8 mg of PADMA (calculated from recommended human daily dose) or 0.085 mg (dose in the range of active doses of other herbal extracts studied by us previously). RESULTS: Highly significant increase of newly formed blood vessels number in ex vivo cutaneous lymphocyte-induced angiogenesis test (LIA) after grafting of Balb/c splenocytes from both dosage groups to F1 hybrids (Balb/c × C3H); increase of blood lymphocytes and granulocytes number only in mice fed with lower dose of remedy; and significant suppression of metabolic activity (chemiluminescence test) of blood granulocytes in mice fed with higher dose of PADMA. CONCLUSION: PADMA 28 behaves as a good stimulator of physiological angiogenesis, but for this purpose it should be used in substantially lower doses than recommended by producers for avoiding the deterioration of granulocyte function.

Numerical model of human head phantom to ensure dosimetry of dose components for boron neutron capture therapy.

Extremely important aspects of the boron neutron capture therapy are, first of all, administering to the patient a boron compound that selectively reaches the neoplastic cells, and in the second step, the verification of the irradiation process. This paper focuses on the latter aspect, which is the detailed dosimetry of the processes occurring after the reaction of thermal neutrons with the boron-10 isotope. The results of computer simulations with the use of a new type of human head phantom filled with a polymer dosimetric gel will be presented in this article.

Characterization of a bacteriophage, isolated from a cow with mastitis, that is lytic against Staphylococcus aureus strains.

Methicillin-resistant strains of Staphylococcus aureus (MRSA) are now the most commonly reported antibiotic-resistant bacterium in clinical settings. Therefore, there is an urgent need to develop novel antibacterial agents to control this pathogen. Bacteriophage therapy is a potential alternative treatment for MRSA infections. The objective of this study was characterization of a novel virulent bacteriophage (MSA6) isolated from a cow with mastitis. Electron microscopy showed its resemblance to members of the family Myoviridae, with an isometric head (66 nm) and a long contractile tail (173 nm). The genome of phage MSA6 was tested by pulsed-field gel electrophoresis and estimated to be about 143 kb. It exhibited rapid adsorption (>82% in 5 min), a short latent period (15 min) and a relatively small burst size (23 PFU/cell). Isolated phage was capable of infecting a wide spectrum of staphylococcal strains of both human and bovine origin. The results of this investigation indicate that MSA6 is similar to other bacteriophages belonging to the family Myoviridae (Twort, K, G1, 812) that have been successfully used in bacteriophage therapy.

Isolation and characterization of a novel bacteriophage φ4D lytic against Enterococcus faecalis strains.

In recent years, Enterococcus faecalis has emerged as an important opportunistic nosocomial pathogen capable of causing dangerous infections. Therefore, there is an urgent need to develop novel antibacterial agents to control this pathogen. Bacteriophages have very effective bactericidal activity and several advantages over other antimicrobial agents and so far, no serious or irreversible side effects of phage therapy have been described. The objective of this study was to characterize a novel virulent bacteriophage φ4D isolated from sewage. Electron microscopy revealed its resemblance to Myoviridae, with an isometric head (74 ± 4 nm) and a long contractile tail (164 ± 4 nm). The φ4D phage genome was tested using pulsed-field gel electrophoresis and estimated to be 145 ± 2 kb. It exhibited short latent period (25 min) and a relatively small burst size (36 PFU/cell). Tests were conducted on the host range, multiplicities of infection (MOI), thermal stability, digestion of DNA by restriction enzymes, and proteomic analyses of this phage. The isolated phage was capable of infecting a wide spectrum of enterococcal strains. The results of these investigations indicate that φ4D is similar to other Myoviridae bacteriophages (for example φEF24C), which have been successfully used in phagotherapy.

Sample study protocol for adapting and translating the 5C scale to assess the psychological antecedents of vaccination.

INTRODUCTION: Published in 2018, the 5C scale is psychometrically validated to assess five psychological antecedents of vaccination (confidence, complacency, constraints, calculation and collective responsibility). The original version offers a validated English and German scale to assess these determinants with a short 5-item scale (1 item per antecedent) and a long 15-item scale (3 items per antecedent). This sample study protocol provides a step-by-step guidance for the process of adapting the 5C scale to another country, language or cultural context. Data obtained from the 5C scale can support developing, implementing and evaluating an intervention and monitoring of general vaccine acceptance and demand. METHODS AND ANALYSIS: Phase 1 comprises the adaptation of the 5C scale including the translation and back translation of the antecedents, an expert evaluation of the antecedents and the identification of new antecedents as well as a pretest. Phase 2 involves the validation of the translated and potentially expanded scale including the assessment of reliability, construct and concurrent validity of all items of the scale. Code for data analysis is provided. ETHICS AND DISSEMINATION: The University of Erfurt's institutional review board provided ethical clearance (EV-201900416.2). The authors suggest and encourage publicly sharing all data obtained from the translated 5C scale (eg, on publication). The materials and the code for data analysis to support the process described in this protocol are available in https://osf.io/2agxe/. Sharing data on vaccine acceptance and demand is in the public and the scientific interest and will facilitate gaining a global overview of its current state and development over time. The authors of the original 5C scale are currently working on an online platform to facilitate publishing the data and to visualise the psychological antecedents across different countries.

[The substances active against influenza virus. Possibilities and prospects of application]. / Substacje przeciwwirusowe aktywne dla wirusa grypy. Mozliwosci i perspektywy zastosowania.

Influenza, especially pandemic influenza, poses great threat to health and humans life of. Due to the antigenic drift and shift of the influenza virus, there is a constant requirement to accurately adjust contents of the vaccine to current subtype of the virus. As there is always a long period of time between the moment of detection of a new kind of influenza virus till a new vaccine is produced, the only protection for the people are antiviral drugs. Some examples of antiviral compounds that can be used in treatment in near future have been presented. A review of the researches on the substances that are active against influenza viruses has been carried out and their mechanism of action was described. We have taken into account the chemical compounds that seem to be active in the process of virus adsorption; hemagglutinin and neuraminidase inhibitors; M2 ion channel blockers; polymerase, endonuclease, transcriptase, proteine kinase and signaling cascade inhibitors. The potential of oligonucleotide antiviral therapeutics and the substances that are extracted from different plants were presented. The future direction of research were shown.

[Selected research problems of anthrax vaccine development]. / Wybrane kierunki badan nad szczepionkami przeciwko waglikowi.

The threat of bioterrorism with B. anthracis against civilian population is one of major concern. After successful bioterroristic attack in 2001 in US renewed research interest has prompted in the development of new and more effective vaccine against anthrax. There are two licensed vaccines against anthrax--AVA-Bio-Thrax US and UK--sterile culture filtrate prepared by alum precipitation. Both vaccines are based on PA antigen. There are several concerns regarding PA based vaccines. They require six sc injections and yearly booster, high rates of local reaction after vaccination is observed, the immunity is not long lasting, vaccination do not protect animals against different strains of B. anthracis. New strategies in the development of anthrax vaccines have been presented (recombinant PA, subunits vaccine, mutants, conjugated). Using proteomic approaches new antigens have been also identified as candidates for future vaccines. More effective and easy to perform methods of vaccination have been reviewed.

[Syndromic surveillance in circumstances of bioterrorism threat--the essence, application abilities and superiority over a traditional epidemiological surveillance]. / Nadzór syndromowy w sytuacji zagrozenia atakiem bioterrorystycznym--istota, mozliwosci zastosowania oraz przewaga nad tradycyjnym nadzorem epidemiologicznym.

This article provides a short review about trends of developing current syndromic surveillance systems. To improve methods of early detection of natural or bioterrorism-related outbreaks, it has to be established a new way of epidemiological thinking, which uses innovative real-time surveillance systems. Syndromic surveillance has been created for an early detection, to monitor the temporo-spatial spread of an outbreak, and to provide prompt data for immediate analysis and feedback to public health authorities. It supports timely decision making process for countermeasure procedures. Framework of syndromic surveillance system requires a proper electronic infrastructure to be build up. Optimal syndrome definitions and data sources for continuing specific diseases outbreak surveillance have not been determined so far. Systems of interest might enhance collaboration among clinical providers, primary care providers, emergency services, information-systems professionals and public health agencies. However economic scope of this undertakings effectively limits ability to implement it in Polish public health service right now. Besides, syndromic surveillance cannot replace traditional public health surveillance with a post-factum epidemiological investigation and laboratory analysis. It can be a useful supplement.

Microbiological analysis of bioaerosols collected from Hospital Emergency Departments and ambulances.

INTRODUCTION AND OBJECTIVE: The goal of the study was a microbiological, qualitative and quantitative analysis of bioaerosol at the workplace of medical personnel (Health Emergency Departments (HEDs), ambulances), and comparative administration offices with an expected neutral occupational exposure to biological agents measured with individual Button Sampler. MATERIAL AND METHODS: Personal sampling was performed with Button Sampler instrument loaded with gelatine filters in 10 HEDs, in 9 ambulances and in 9 offices to assess the occupational biological agents' exposure in air. Sampling was conducted from March until April 2016. Samples were quantitatively assessed for viable and total number of bacteria and fungi. Routine procedures for microbiological diagnostics were implemented. Data were analysed using Kruskal-Wallis and Mann-Whitney statistical tests with α=0.05. P value less than 0.05 were considered significant. RESULTS: At the workplaces assessed, the concentrations of viable microorganisms in HEDs were 1.3×102 - 4.2×103 CFU/m3 for bacteria, 3.4×100 - 8.1×101 CFU/m3 for fungi; in ambulances 1.3×102 - 1.4×103 CFU/m3 (bacteria), 6.7×100 - 6.5×102 CFU/m3 (fungi) and in offices 4.2×101 - 5.0×103 CFU/m3 (bacteria), 0 - 7.9×102 CFU/m3(fungi). In outdoor air, the number of microorganisms reached the level: 1.0×102 - 5.9×102 CFU/m3 for bacteria and 1.5×102 - 8.2×102 CFU/m3 for fungi. The predominant isolated bacteria were Gram-positive cocci. The prevalent fungi species belonged to the genus Aspergillus and Penicillium. CONCLUSIONS: The quantitative assessment of examined indoor air was similar to control outdoor air, and were relatively low. The level of microbiological contamination did not exceed 5×103 CFU/m3 which is recommended as an admissible level in public spaces in Poland.

Identification and characteristics of biological agents in work environment of medical emergency services in selected ambulances.

OBJECTIVES: Assessment of microbial air quality and surface contamination in ambulances and administration offices as a control place without occupational exposure to biological agents; based on quantitative and qualitative analysis of bacteria, yeasts and filamentous fungi found in collected samples. MATERIAL AND METHODS: The sampling was done by wet cyclone technology using the Coriolis recon apparatus, imprint and swab methods, respectively. In total, 280 samples from 28 ambulances and 10 offices in Warszawa were tested. Data was analyzed using Shapiro-Wilk normality test, Kruskal-Wallis test with α = 0.05. P value ≤ 0.05 was considered as significant. RESULTS: The levels of air contamination were from 0 to 2.3×101 colony-forming unit (CFU)/m3 for bacteria and for yeast and filamentous fungi were from 0 to 1.8×101 CFU/m3. The assessment of office space air samples has shown the following numbers of microorganisms: bacteria from 3.0×101 to 4.2×101 CFU/m3 and yeast and filamentous fungi from 0 to 1.9×101 CFU/m3. For surface contamination the mean bacterial count in ambulances has been between 1.0×101 and 1.3×102 CFU/25 cm2 and in offices - between 1.1×101 and 8.5×101 CFU/25 cm2. Mean fungal count has reached the level from 2.8×100 to 4.2×101 CFU/25 cm2 in ambulances and 1.3×101 to 5.8×101 CFU/25 cm2 in offices. The qualitative analysis has revealed the presence of Acinetobacter spp. (surfaces), coagulase - negative Staphylococci (air and surfaces), Aspergillus and Penicillium genera (air and surfaces). CONCLUSIONS: The study has revealed a satisfactory microbiological quantity of analyzed air and surface samples in both study and control environments. However, the presence of potentially pathogenic microorganisms in the air and on surfaces in ambulances may endanger the medical emergency staff and patients with infection. Disinfection and cleaning techniques therefore should be constantly developed and implemented. Int J Occup Med Environ Health 2017;30(4):617-627.

Microarrays--new possibilities for detecting biological factors hazardous for humans and animals, and for use in environmental protection.

Both the known biological agents that cause infectious diseases, as well as modified (ABF-Advanced Biological Factors) or new, emerging agents pose a significant diagnostic problem using previously applied methods, both classical, as well as based on molecular biology methods. The latter, such as PCR and real-time PCR, have significant limitations, both quantitative (low capacity), and qualitative (limited number of targets). The article discusses the results of studies on using the microarray method for the identification of viruses (e.g. Orthopoxvirus group, noroviruses, influenza A and B viruses, rhino- and enteroviruses responsible for the FRI (Febrile Respiratory Illness), European bunyaviruses, and SARS-causing viruses), and bacteria (Mycobacterium spp., Yersinia spp., Campylobacter spp., Streptococcus pneumoniae, Salmonella typhi, Salmonella enterica, Staphylococcus aureus, Neisseria meningitidis, Clostridium difficile , Helicobacter pylori), including multiple antibiotic-resistant strains. The method allows for the serotyping and genotyping of bacteria, and is useful in the diagnosis of genetically modified agents. It allows the testing of thousands of genes in one experiment. In addition to diagnosis, it is applicable for gene expression studies, analysis of the function of genes, microorganisms virulence, and allows the detection of even single mutations. The possibility of its operational application in epidemiological surveillance, and in the detection of disease outbreak agents is demonstrated.