European Journal of Clinical and Experimental Medicine T.20, z. 3 (2022)

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Monitoring of infliximab treatment in inflammatory bowel diseases – basic knowledge and current data based on clinical trials in a population of Polish patients
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2022-12) Pękala, Anna
Introduction and aim. Infliximab is the oldest biological drug belonging to the group of tumor necrosis factor antagonists. Despite the availability of many new biological therapies, this drug still plays an important role in the treatment of inflammatory bowel diseases. However, a significant problem related to pharmacotherapy is the high inter-individual variability of the response. Material and methods. This study presents results of the research on the treatment with infliximab in the inflammatory bowel disease (IBD) patients including our own experience in Polish IBD patients. Analysis of the literature. Therapeutic failure while using infliximab can be attributed partly to inadequate serum concentrations of the drug and the development of anti-drug antibodies. Many studies have attempted to find a relationship between the specific level of infliximab and the achieved healing effect. These analyses show that the optimal level of the drug differs depending on the type of disease, its phenotype, and therapeutic goal and that the optimization of infliximab therapy remains an open topic. Two studies involving the population of Polish IBD patients examined the level of infliximab during and after induction, as well as the frequency of anti-drug antibodies. Two studies involving a population of Polish IBD patients examined the level of infliximab during and after induction, as well as the frequency of anti-drug antibodies. These studies demonstrated the need for monitoring infliximab treatment at weeks 6 and 14. Conclusion. Reactive monitoring is believed to enable the most rational treatment decisions; however, experts also recommend that proactive monitoring should measure infliximab concentrations at the end of induction and at least once during maintenance treatment.
"Valeriana officinalis" – a review
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2022-12) Mytych, Wiktoria; Aebisher, David
Introduction and aim. "Valeriana officinalis" has been recognized in traditional medicine and used since ancient times for a variety of health ailments. It is mainly appreciated for its sedative and sleeping properties. Currently, scientists are conducting numerous studies on the exact chemical composition of valerian and the properties they carry in the human body. Material and methods. This paper presents a narrative review on valerian. Analysis of the literature. The desire to summarize information on the uses and properties of V. officinalis is presented. V. officinalis exhibits sedative, sleep-inducing and antidepressant properties. Studies show broad effects on the human nervous system, for example, reducing stress. Conclusion. By discovering new properties of valerian, its properties are expanding significantly day by day. Its main use is primarily in the treatment of sleep disorders and nervous system disorders. However, it is also used in headaches, depression, anti-cancer therapy, urinary and digestive disorders. More and more people are turning to valerian as an alternative to drugs that have more side effects.
“Silybum marianum” – properties and application in medicine – a review
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2022-12) Sowińska, Marta; Szpunar, Magdalena
Introduction and aim. The subject of this article is milk thistle – a plant belonging to the Asteraceae family. Due to its properties, it has a beneficial effect on the functioning of important organs and systems of the human body. The aim of this paper was to review information on milk thistle, its use in medicine and the description of some of the chemical compounds due to which it owes its healing properties. Material and methods. The article is a review of the publicly available literature on milk thistle, the chemical composition of its compounds and its use in medicine. Analysis of the literature. Current information about “Silybum marianum” is presented. Conclusion. Milk thistle is a valuable medicinal plant due to the presence of numerous antioxidant and anti-inflammatory compounds. The benefits of supplementation with ingredients derived from milk thistle, their negligible interaction with other drugs and the lack of significant side effects, known so far, indicate that the plant described in the article can be a good medicine and a preventive measure against diseases affecting our society.
Comparison of conventional syringe anesthesia and three computer-aided anesthesia systems (Quicksleeper, SleeperOne, and The Wand)
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2022-12) Singh, Nisha; Wyzga, Sylvia; Yune, Jessica; Mathur, Gauri; Błochowiak, Katarzyna
Introduction and aim. The purpose of this study was to compare different Computerized-Controlled Local Anesthetic Delivery (CCLAD) systems to one another in addition to the conventional syringe. Material and method. The CCLAD systems chosen for this study are the Quicksleeper, SleeperOne, and The Wand. These are discussed in categorical objectives, including the following: duration of anesthesia, analgesic effect, locality; anxiolytic effect; advantages and disadvantages; comfort and safety of use; limitations. Analysis of the literature. The research found that many factors influence the effectiveness of dental injections, and the CCLAD systems are designed to reduce the ones that cause negative experiences. The injection systems are unique in their descriptions but show many similarities. Conclusion. The research concluded that each device has its advantages and disadvantages and that its efficiency depends on outlying factors, independent of the injection system used.
Gastroprotective effects of Prunus laurocerasus L. fruit extracts against the oxidative stress induced by indomethacin in rats
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2022) Berktas, Ozlem Aydin; Keskin, Arif; Gulec Peker, Emine Gulceri
Introduction and aim. Prunus laurocerasus L. is a perennial plant belonging to the Rosaceae family and is grown on the shores of the Black Sea Region. In the current study, the effect of P. laurocerasus fruits was investigated in the ulcer model created by the application of indomethacin to rats. Material and methods. Rats divided into five groups: fruit water extract (200 mg/kg), fruit ethanol-water extract (200 mg/kg), lansoprazole agent (LAN, 25 mg/kg), and indomethacin (IND, 25 mg/kg). All administrations were given to animals by oral gavage. At the end of the experiment, macroscopic and biochemical measurements were made in rats. Results. The lipid peroxidation was quite high in rat stomach tissues given IND. The applied LAN and extracts reduced this increase to almost a healthy rate. On the other hand, the amount of glutathione, catalase, and superoxide dismutase activities were found very low in IND applied tissues. The LAN and fruit extracts treatments tried to show their protective feature by increasing this decreased antioxidant level in their own groups. Conclusion. The data obtained determined that both enzyme and non-enzyme antioxidant markers measured in fruit extracts had a protective effect almost as strong as lansoprazole.
Predictors of blood pressure levels, knowledge and practices of adult hypertensives attending a Secondary Health Care Centre in South-Western Nigeria
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2022-12) Azeez Ismaheel, Aderogba; Dairo, Magbagbeola David; Akinyemi, Joshua Odunayo; Idowu, Olufemi Philippe
Introduction and aim. The prevalence of hypertension is increasing with accompanying poor control. The aim of this study was to assess the predictors of knowledge and practices of adult hypertensives. Material and method. The study was a prospective (before and after) study with health education as the intervention. A simple random sampling technique with computer-generated random numbers was used to recruit 386 patients. Data were analysed using SPSS version 23. Logistic regressions were used to determine the predictors of knowledge and practices. Results. Those who had tertiary education were about four times more likely to have good knowledge of hypertension than those who had secondary education (OR=0.256; 95% CI=0.106–0.617). The females were about 1.73 times more likely to have good practices of hypertension than males (OR=1.729; 95% CI=1.008–2.966). For every 1 unit increase in the body mass index, there was a statistically significant increase in diastolic blood pressure by about 0.22 units (95% CI=0.046–0.394, p=0.013). The health education had a positive impact on the blood pressure reduction. Conclusion. The predictors of knowledge of hypertension, practices of hypertensives and diastolic blood pressure were level of education, sex, and body mass index respectively.
Mentat® ameliorates hypoxia-induced attention deficyt hyperactivity disorder like behavior in rats
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2022-12) Sindhura, Sai; Viswanatha, Gollapalle Lakshminarayanashastry; Jain, Chirag; Mallappa, Onkaramurthy; Azeemuddin, Mohammed Mukhram; Rafiq, Mohamed; Manjula, S.N.
Introduction and aim. The objective of the study was to evaluate the effect of MentatR an herbal formulation in experimental models of hypoxia-induced attention deficit hyperactive disorder (ADHD) like behavior in rats. Material and methods. MentatR was evaluated at the dose of 100 and 200 mg/kg body weight. per oral., in two experimental models of hypoxia in Wistar rats. In the first model, after parturition, on a postnatal day 2 (PND-2), the pups were subjected to hypoxic exposure for 10 minutes to induce neonatal hypoxia. Pups were weaned from dams on PND-21 and subjected to drug treatments for 10 days. In the second model, phenytoin 150 mg/kg. b.wt. p.o. was administered orally to all pregnant animals throughout gestation to induce intrauterine hypoxia. Pups were subjected to assigned treatments after weaning. Behavioral and biochemical parameters relevant to ADHD were assessed. Results. In the positive control group, hypoxic exposure resulted in significant changes in cognitive and neurologic skills compared to normal control. Open field test, elevated plus maze test, and Acetylcholine esterase levels showed a significant increase in positive control compared to normal control. In treatment groups, there was a dose-dependent decrease in all the above parameters compared to positive control. Dopamine and Nor-epinephrine levels in brain homogenate were decreased in positive control which subsequently increased with MentatR treatment. Conclusion. MentatR showed a neuroprotective effect in different experimental models of ADHD. It may be recommended for the effective/preventive management of ADHD, especially associated with memory impairment and neurologic conditions.
The effects of acute high intensity interval training on hematological parameters and neutrophils to lymphocytes ratio in elite taekwondo athletes according to gender
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2022-12) Işık, Bülent; Küççüktürk, Serkan; Yüksel, Mehmet Fatih; Boyalı, Ekrem; Karaselek, Mehmet Ali; Erdağı, Kenan
Introduction and aim. Intense taekwondo (TKD) training, it is important to know the exercise-induced hematological and inflammatory conditions and to develop conditions suitable for physiological needs. The aim of study is to investigate the effects of TKD-specific training containing a high-intensity interval training (HIIT) component hematological parameters and on systemic inflammatory biomarkers between gender. Material and methods. The research was carried out with twenty-four elite TKD athletes (12 female, 12 male). 90 minutes of TKD-specific unit training, including 50 minutes of HIIT component was applied to the athletes. Hematological parameters included erythrocytes, platelets, leukocytes and their subgroups and inflammatory biomarkers. Results. With the effect of TKD-specific HIIT, erythrocytes and hematocrit values decreased regardless of gender (p=0.003, p<0.001, respectively). Platelet values decreased in male and increased in female (p=0.637). White blood cells and neutrophil (p<0.001) and inflammatory biomarkers neutrophils-to-lymphocytes ratio (NLR) and platelet-to-lymphocytes ratio PLR (p<0.001, p=0.022, respectively) increased regardless of gender. Lymphocyte decreased marginally significantly (p=0.059). Conclusion. This study showed that TKD-specific HIIT increased systemic inflammatory conditions and decreased oxygen-carrying blood parameters. These fundamental findings can contribute to training science in arranging a specific taekwondo training program and sports medicine in protecting the health of athletes.
Correlation of the end-tidal CO2 value with arterial blood gas parameters – evaluation of the treatment efficacy of COPD exacerbation in the emergency department
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2022-12) Çakmak, Fatma; Tekin, Erdal
Introduction and aim. Painful, invasive, and expensive arterial blood gas (ABG) analysis is required in the diagnosis, follow-up, treatment, and even discharge of patients with chronic obstructive pulmonary disease (COPD). This study aimed to compare the end-tidal carbon dioxide (ETCO2) value, which allows non-invasive, painless, low-cost, and continuous monitoring, with ABG parameters, in the evaluation of the treatment efficacy of COPD exacerbation. Material and methods. The study was prospectively conducted with patients who presented to the emergency department with COPD exacerbation. ABG analysis and ETCO2 measurement were simultaneously performed in patients with COPD exacerbation at the time of arrival and after treatment, and were statistically compared. Results. The study included a total of 216 patients, of whom 57.4% were male. The mean age of the patients was 67.3±13.9 years. The ETCO2 values of the patients at arrival and after COPD exacerbation treatment were 39.2±10 and 37.3±9, respectively, and a statistically significant difference was determined (p=0.001). The partial pressure of pCO2 values measured at arrival and after treatment were 40.85±10.54 and 38.74±9.25, respectively, and it was statistically significant (p=0.001). A strong positive and statistically significant correlation was found between the ETCO2 and pCO2 values both at arrival and after COPD exacerbation treatment (r=0.840; p<0.001 and r=0.872; p<0.001, respectively). The Bland-Altman plot was constructed for the agreement between ETCO2 and pCO2 at both evaluation times. Conclusion. ETCO2 measurement could accurately predict the pCO2 of patients with COPD at arrival and after COPD exacerbation treatment. Also, ETCO2 may be useful in cases where pCO2 cannot be used.
Circulatory and ventilatory power markers in patients with diabetes mellitus – influence of glycemic control
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2022-12) Menegalli Santos, Letícia; Donisete Da Silva, Claudio ; Lorevice, Laura Beatriz; Italiano Monteiro, Clara ; Ricci, Paula Angélica ; Borghi-Silva, Audrey; Gonçalves Mendes, Renata
Introduction and aim. Cardiorespiratory function has been shown to be impaired in individuals with type 2 diabetes mellitus (T2DM). Some deficiencies in cardiopulmonary exercise test (CPET)-derived variables are known, however, the influence of glycemic control on cardiovascular integrity indices as circulatory power (CP) and ventilatory power (VP), deserve to be instigated. The aim was to investigate the influence of glycemic control on CP and VP indices in T2DM. Material and methods. T2DM individuals of both sexes aged between 40 and 64 years were allocated into two groups: Good glycemic control (GGC, n=11; HbA1c≤7%) and insufficient glycemic control (IGC, n=26; HbA1c>7%). All participants underwent a CPET on a treadmill using a gas analyzer and a laboratory blood test. CP values were obtained by the product of peak of oxygen uptake and systolic blood pressure (SBP) and VP by dividing SBP by the ventilatory efficiency (VE/VCO2 slope). The level of significance was set at p<0.05. Results. No baseline differences were found between the groups, except for the expected fasting glucose and glycated hemoglobin. No differences were found between GGC and IGC groups for CP (4756.05±1061.67 and 4434.15±1247.83 mmHg.ml.kg-1min-1, p=0.460) and VP (5.85±1.08 and 5.86±1.31 mmHg, p=0.978), respectively. Conclusion. CP and VP were similar in individuals with T2DM regardless of glycemic control. Predictive ability of these variables in health outcomes deserves to be further investigated in T2DM.
The role of the hematological inflammatory index and systemic immuno-inflammation index in acute cholecystitis
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2022-12) Özdemir, Serdar; Altunok, İbrahim; Abuzer, Özkan; İslam, Mehmet Muzaffer; Algın, Abdullah; Eroğlu, Serkan Emre; Aksel, Gökhan
Introduction and aim. Acute cholecystitis is one of the most common hepatobiliary emergencies. We aimed to investigate the role of the initial hematological inflammatory index and systemic immuno-inflammation index in predicting short-term mortality in patients with acute cholecystitis. Material and methods. This study with a retrospective observational design was conducted at the emergency department of a tertiary teaching hospital. Patients admitted to our clinic between June 15, 2021, and March 15, 2022, according to the Tokyo criteria were included in the sample. The hematological inflammatory index and systemic immuno-inflammation index were calculated using the hematological test results of the patients evaluated at the emergency department. Survivor and non-survivor groups were formed according to all-cause 30-day mortality. The differences between survivor and non-survivor groups were investigated. Results. A total of 194 patients were included in the final analysis. The median age of the study population was 59 (25th–75th percentiles: 46.75–72) years. The rate of all cause-short-term mortality was 7.7. There were significant differences between the survivor and non-survivor groups in terms of the neutrophil count and the systemic immuno-inflammation index (p=0.007, 0.034, respectively; Mann-Whitney U test). No significant difference was found in the remaining laboratory parameters (lymphocyte count, platelet count, and hematological inflammatory index) (p=0.220, 0.489, 0.367 respectively; Mann-Whitney U test). Conclusion. The systemic immuno-inflammation index was determined to be significantly higher in the non-survivor group than in the survivor group among the patients with acute cholecystitis. However, there was no significant difference between these two groups in relation to the hematological inflammatory index.
The incidence of obesity among children in Turkey – obesity awareness, physical activity and other associated factors
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2022-12) Topan, Aysel; Ocakcı, Ayse Ferda; Ayyıldız, Tulay Kuzlu; Kurt, Aylin; Ozdemir, Sümeyye
Introduction and aim. Obesity is the leading one among the most common nutritional disorders seen during childhood period. We aimed to determine the incidence of obesity, obesity awareness, physical activity and associated factors in school-age children. Material and methods. The sampling was composed of 725 students who were studying in secondary schools during the 2016–2017 academic year. Data were collected with “Personel Information Form”, “Obesity Awareness Scale” and “Physical Activity Questionnaire for Older Children”. The mean age was 12.30±1.32 (10–15), 53% of the students were females and 60.1% of students have a person with obesity in the family. Results. We determined that 18.3% of the students were with obesity. The body mass index of students who have a balanced diet compared to those who have not is statistically significantly lower (p<0.05). There was a significant relationship between students’ body mass index and obesity awareness (r=-0.084, p=0.024). Conclusion. Screening for obesity and related factors, such as obesity awareness, having a balanced diet should begin in school-aged children for childhood obesity prevention.
Predictive value of blood urea nitrogen to serum albumin ratio in estimating in-hospital mortality in patients with upper gastrointestinal bleeding
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2022-12) Kurt, Erdem; Kurt, Sebnem Zeynep Eke
Introduction and aim. The aim of this study was to examine the usability of blood urea nitrogen to serum albumin ratio (BAR) as a prognostic predictor of in-hospital mortality in patients with gastrointestinal (GI) bleeding. Material and methods. The electronic medical records of the patients who applied to the emergency department due to upper GI bleeding during the study period were reviewed. The receiver operating characteristic (ROC) curve and the area under the curve (AUC) were used to evaluate each discriminant cut-off value to estimate mortality. Results. The study included 225 patients. The median (IQR) age of the patients was 75.0 (68.0–84.0) and 94 (41.8%) were female. AUC was determined as 0.784±0.055 (95% CI, 0.677–0.892) for BAR (p<0.001) in terms of in-hospital mortality. The cut-off value of BAR for this outcome was calculated as 16.26. In this cut-off value, sensitivity was 71.43%, specificity 82.84%, positive predictive value (PPV) 30.00% and negative predictive value (NPV) 96.57%. Conclusion. BAR is a useful tool that can be used to predict the in-hospital mortality of patients with GI bleeding. Patients with GI bleeding with a BAR above 16.26 will require more aggressive and timely intervention.
Nonthyroidal illness syndrome as independent predictor of hospital mortality in the elderly hospitalized patients with COVID-19 pneumonia – single-center observation
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2022-12) Młodożeniec, Aleksandra; Orłowska-Florek, Renata; Czarnożycka-Wróbel, Adrianna; Gargasz, Krzysztof; Gala-Błądzińska, Agnieszka
Introduction and aim. Elderly patients with COVID-19 are at increased risk for adverse outcomes. This study aims to evaluate the prevalence of nonthyroidal illness syndrome (NTIS) in hospitalized patients with COVID-19 pneumonia, its independent impact on patients’ survival. Furthermore, to investigate selected inflammatory biomarkers in those patients and to determine whether they predict mortality associated with the disease. Material and methods. In this single-centered, retrospective study, the medical records of 53 patients with confirmed SARSCoV- 2 infection who attended the provincial hospital between October 2020 and January 2021 were reviewed. Demographic data, laboratory values, comorbidities, treatments, and clinical outcomes were collected. We compared the data in survivor and non-survivor groups. Results. Of 393 adult patients with SARS-CoV-2 pneumonia, 53 (13,49%) met the inclusion criteria and were included. The median age was 72±12.2 years, 26 patients (49%) were men. The NTIS prevalence was 62.3% and showed a strong independent correlation with disease severity and mortality in COVID-19 patients (p=0.01). The interleukin-6, white blood cells, ferritin and neutrophil ratios also differed significantly statistically between survivors and non-survivors. Conclusion. NTIS and the lowering level of FT3 pose an independent prognostic marker of clinical deterioration and higher mortality in elderly patients with COVID-19.
Comparative analysis of patients’ satisfaction level, hospitalized before and during the COVID-19 pandemic
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2022-12) Wójcik, Rena; Adam, Anna; Golonka, Ewa
Introduction and aim. Measurement of the satisfaction level with health services is the most frequently used indicator, mainly because of its importance for determining the quality of the care offered. It is the key to succeed in achieving high-quality healthcare. The purpose of this study was to create a retrospective comparative analysis of the satisfaction level amongst patients hospitalized before and during the COVID-19 pandemic. Material and methods. The study covered a total of 966 patients in 19 hospital wards, in the fourth quarter of 2019 (before the pandemic) and in the second quarter of 2021 (during the pandemic) at the Masovian Specialist Hospital in Radom. The level of patient satisfaction was assessed based on the questionnaire prepared and approved by the Quality Assurance Team in the Masovian Specialist Hospital. The statistical analysis was carried out on the basis of the STATISTICA 10.1 program, using the Pearson’s chi square test, for the significance level at p<0.05. Results. The high level of satisfaction of patients staying in the hospital during the pandemic applied to the widely understood medical and nursing care as well as sanitary conditions in wards, especially the cleanness of rooms, bed linens and sanitary facilities. Conclusion. The biggest dissatisfaction of hospitalized patients during the COVID-19 pandemic involved certain restrictions of visitations and using pastoral services.
The relationship between the COVID-19 pandemic and the sexual life quality of nurses
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2022-12) Ekrem, Ebru Cirban; Erciyas, Şeyma Kilci
Introduction and aim. Sexuality is one of the basic human needs. The coronavirus has adversely affected every aspect of people’s lives. The nurses who were in the closest contact with the patients were affected more negatively due to the many unknowns during the COVID-19 pandemic. Aim of this study is to determine the relationship between the COVID-19 pandemic and the sexual quality of life of nurses. Material and methods. The sample of this descriptive-cross-sectional study consisted of 390 nurses who met the inclusion criteria. The data were collected over the social networks between November 2020-January 2021. The data were collected through social networks using the “Personal Information Form” and “Quality of Sexual Life Scale-Women” using the self-report method. Results. The mean age of the nurses was 32.44±6.83, and 59.2% of them had a university level education. The mean score of the women’s sexual quality of life scale was calculated as 87.37±20.83. It has been determined that there is a statistically significant difference between the scores obtained from the sexual life quality scale according to the status of the nurses having (p<0.05). Conclusion. In the COVID-19 pandemic, it was determined that the sexual life quality of nurses was above the medium level and their sexual life was adversely affected.

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