Burnout and Life Satisfaction among Healthcare Workers Related to the COVID-19 Pandemic (Silesia, Poland).

Background: The phenomenon of burnout among healthcare workers during the COVID-19 pandemic is a widespread problem with several negative consequences for the healthcare system. The many stressors of the pandemic have led to an increased development of anxiety and depressive disorders in many healthcare workers. In addition, some manifested symptoms of the so-called postpandemic stress syndrome and the emergence of occupational burnout syndrome, commonly referred to as "COVID-19 burnout." The aim of this study was to assess the burnout and life satisfaction of healthcare workers during the COVID-19 pandemic. Materials and Methods: The study was conducted in 2020-2022 among medical staff working in hospitals in Silesia, Poland. The instruments used to assess life satisfaction and burnout were the Satisfaction with Life Scale (SWLS) and the Maslach Burnout Inventory (MBI), which assesses three dimensions: emotional exhaustion (EE), depersonalisation (DEP), and sense of reduced professional accomplishment (SRPA). Results: The study group included 900 participants. There were 300 physicians (mean age 38 ± 7 years), 300 nurses (mean age 35 ± 6 years), and 300 paramedics (mean age 31 ± 5 years). Life satisfaction as measured by the SWLS was lowest among nurses and paramedics in 2021 and among doctors in 2022. Male respondents and those with fewer years of work had higher levels of life satisfaction. People with more years of work had higher scores in EE and DEP and lower scores in SRPA (p = 0.001). We found a negative correlation between life satisfaction and EE (p = 0.001), DEP (p = 0.001), and SRPA (p = 0.002). Conclusions: The results highlight the need for further research into the causes of burnout among medical professionals and the need for effective interventions to promote well-being and prevent burnout in this group.

The Association between Circulating Cytokines and Body Composition in Frail Patients with Cardiovascular Disease.

The burden of cardiovascular disease and the percentage of frail patients in the aging population will increase. This study aims to assess the circulating levels of several cytokines in frail patients. This is an ancillary analysis of the FRAPICA trial. The ratio of men/women changed from robust through frail groups from 3:1 to 1:2. The groups are comparable in terms of age and body measurements analysis (weight, height, and BMI), yet the frail patients have significantly reduced fat-free mass, and more often have been diagnosed with diabetes. Frail patients have higher fibroblast growth factor basic (FGF basic) and follistatin levels (borderline significance). In multiple linear regression modeling of fat-free mass, we identified FGF basic, osteopontin, stem cell factor, soluble suppression of tumorigenicity 2, soluble epidermal growth factor receptor, soluble human epidermal growth factor receptor 2, follistatin, prolactin, soluble interleukin 6 receptor alfa, platelet endothelial cell adhesion molecule 1, soluble vascular endothelial cell growth factor receptor 1, leptin, soluble angiopoietin/tyrosine kinase 2, and granulocyte colony-stimulating factor. We have identified a few cytokines that correlate with fat-free mass, a hallmark of frailty. They comprise the kinins implicated in bone and muscle metabolism, fibrosis, vascular wall function, inflammation, endocrine function, or regulation of bone marrow integrity.

Postpandemic Stress Disorder among Health Care Personnel: A Cross-Sectional Study (Silesia, Poland).

Background: Postpandemic stress disorder (PPSD) is an unofficial term that refers to posttraumatic stress disorder (PTSD), a mental disorder resulting from increased stress, anxiety, and trauma associated with unpleasant life experiences. Many scientific studies indicate that symptoms of increased stress, job burnout, anxiety, and depressive disorders are associated with medical personnel performing their professional duties around COVID-19 patients. Objective: The purpose of this study was to assess the prevalence of symptoms that may indicate the presence of PPSD symptoms-depression, anxiety, and stress-in medical personnel. Material and Methods. The survey included 300 people, representatives of medical personnel. The group was divided into two sections. The first section numbered 150 and consisted of personnel in direct contact with COVID-19 patients (FR); the second group also consisted of 150 medical professionals, who but no longer directly involved in helping with COVID-19 cases (SR). The survey was conducted by indirect survey method using CAWI (computer-assisted web interview). The survey used a questionnaire technique. A proprietary tool enriched with standardized psychometric scales: BDI, GAD-7, FCV-19S, and PSS-10 was used. Kruskal-Wallis and Mann-Whitney U statistical tests were used in the statistical processing of the data. The probability level was 0.05. Results: Statistical inference made it clear that mental health problems that may indicate trauma are mainly present in the FR group. These symptoms decreased slightly in comparison between periods 2020 and 2021 (p < 0.05). Conclusions: The COVID-19 pandemic significantly increased the prevalence of depression, anxiety, and stress among first responders. To ensure the psychological well-being of first responders, early assessment and care of mild depression, anxiety, and stress should be promoted to prevent the development of moderate and severe forms.

Comparison of the Prevalence of Eating Disorders among Dietetics Students and Students of Other Fields of Study at Selected Universities (Silesia, Poland).

Background: Over the past few years, an increase in the incidence of eating disorders has been noted. An increase in the pace of life, an increase in the availability of a wide variety of food products, and, to a large extent, the involvement of mass media are cited as reasons for this phenomenon. The promotion of a slim figure by the mass media is equated with achieving success in life, but also the advertising of a wide selection of food products (often highly processed) can have a serious impact on the development of eating disorders. This phenomenon is particularly observed in industrialized Western countries. Objective: Therefore, it was decided to test and compare whether dietetics students are indeed more predisposed to developing eating disorders than students not in the nutrition field. Material and methods: the study included 310 individuals representing two equal groups of fields of study­dietetics and other students. The study used standardized questionnaire­EAT-26. Results: It was found that almost half (46%) of the respondents (both dietetics students and students of other majors) met at least one criterion out of three that could indicate the probable existence or susceptibility to an eating disorder. These individuals should see a specialist for further diagnosis. There was no significant effect of the field of study on the overall EAT-26 test score (p > 0.05). When this result was corrected for BMI values for those with the lowest scores on this indicator, the risk of eating disorders was found to be higher among students of majors other than dietetics (X2 = 13.572; V = 0.831 p = 0.001). Conclusions: Almost half of the respondents in both study groups showed a predisposition to eating disorders based on the EAT-26 test. Despite the presence of a correlation in individual responses that dietetics students are more predisposed to eating disorders, no such relationship was found according to the final EAT-26 test scores. However, it was observed that non-dietetics students who had low BMI values showed higher tendencies toward behaviors indicative of eating disorders.

Post-Pandemic Stress Disorder as an Effect of the Epidemiological Situation Related to the COVID-19 Pandemic.

According to many experts in the fields of psychology and psychiatry, the destabilization resulting from the coronavirus pandemic may not be as noticeable now as it will be after the pandemic period is over. Undoubtedly, the fact that the surrounding reality is standardized and normalized by many at present contributes to this. In the opinion of many researchers, the scale and degree of trauma experienced by society will only be noticed by many once the pandemic is over. Many also suggest that we will experience post-pandemic stress disorder. This literature review aims to bring together in one place the information that speaks to the nature of the problem, which is post-pandemic stress disorder. The main sections of the paper deal with exposure to the disorder in the general population and a review of the current literature on the subject. The second section deals with a group of medical personnel who are on the direct frontline in the fight against the COVID-19 pandemic; it is assumed here that they are those who are at much higher risk of developing post-pandemic stress disorder.

The Usefulness of Optical Coherence Tomography in Disease Progression Monitoring in Younger Patients with Relapsing-Remitting Multiple Sclerosis: A Single-Centre Study.

The purpose of the study was to assess the usefulness of optical coherence tomography (OCT) in the detection of the neurodegenerative process in younger patients with multiple sclerosis (MS). The study group consisted of 61 patients with a relapsing remitting course of MS (mean age 36.4 ± 6.7 years) divided into two groups: short (≤5 years) and long (>10 years) disease duration. OCT, P300 evoked potential, Montreal Cognitive Assessment, and performance subtests (Picture Completion and Digit Symbol) of the Wechsler Adult Intelligence Scale were performed in all patients. Mean values of most parameters assessed in OCT (pRNFL Total, pRNFL Inferior, pRNFL Superior, pRNFL Temporalis, mRNFL, GCIPL, mRNFL+GCIPL) were significantly lower in MS patients in comparison to controls. And in patients with longer disease duration in comparison to those with shorter. Most OCT parameters negatively correlated with the EDSS score (p < 0.05). No significant correlation was found between OCT results and both P300 latency and the results of psychometric tests. OCT, as a simple, non-invasive, quick, and inexpensive method, could be useful for monitoring the progression of disease in MS patients.

Discordance between Body-Mass Index and Body Adiposity Index in the Classification of Weight Status of Elderly Patients with Stable Coronary Artery Disease.

BACKGROUND AND AIMS: Body-mass index (BMI) is a popular method implemented to define weight status. However, describing obesity by BMI may result in inaccurate assessment of adiposity. The Body Adiposity Index (BAI) is intended to be a directly validated method of estimating body fat percentage. We set out to compare body weight status assessment by BMI and BAI in a cohort of elderly patients with stable coronary artery disease (CAD). METHODS: A total of 169 patients with stable CAD were enrolled in an out-patient cardiology clinic. The National Research Council (US) Committee on Diet and Health classification was used for individuals older than 65 years as underweight BMI < 24 kg/m2, normal weight BMI 24-29 kg/m2, overweight BMI 29-35 kg/m2, and obesity BMI > 35 kg/m2. In case of BAI, we used sex- and age-specific classification of weight status. In addition, body fat was estimated by bioelectrical impedance analysis (BImpA). RESULTS: Only 72 out of 169 patients (42.6%) had concordant classification of weight status by both BMI and BAI. The majority of the patients had their weight status either underestimated or overestimated. There were strong positive correlations between BMI and BImpA (FAT%) (R = 0.78 p < 0.001); BAI and BImpA (FAT%) (R = 0.79 p < 0.001); and BMI and BAI (R = 0.67 p < 0.001). BMI tended to overestimate the rate of underweight, normal weight or overweight, meanwhile underestimating the rate of obesity. Third, BMI exhibited an average positive bias of 14.4% compared to the reference method (BImpA), whereas BAI exhibited an average negative bias of -8.3% compared to the reference method (BImpA). Multivariate logistic regression identified independent predictors of discordance in assessing weight status by BMI and BAI: BImpA (FAT%) odds ratio (OR) 1.29, total body water (%) OR 1.61, fat mass index OR 2.62, and Controlling Nutritional Status (CONUT) score OR 1.25. CONCLUSIONS: There is substantial rate of misclassification of weight status between BMI and BAI. These findings have significant implications for clinical practice as the boundary between health and disease in malnutrition is crucial to accurately define criteria for intervention. Perhaps BMI cut-offs for classifying weight status in the elderly should be revisited.

KNOWLEDGE OF YOUNG WOMEN ABOUT NUTRIENTS INFLUENCING DEVELOPMENT OF FETAL NERVOUS SYSTEM.

OBJECTIVE: The aim: To analyze the nutritional knowledge of women in the reproductive age about nutrients influencing the fetal nervous system's development. PATIENTS AND METHODS: Materials and methods: The study was conducted with a proprietary anonymous questionnaire using the CAWI (Computer Assisted Web Interviews) method among 263 women aged 18-51 years. RESULTS: Results: In 35.4% of the surveyed women, the level of knowledge was insufficient, in 31.9% - sufficient, in 27% - good, and only in 5.7% - very good. The knowledge of the respondents was influenced by education (p < 0.001) and body mass index (BMI, p < 0.001). Women of reproductive age with higher education and/or lower BMI had a better understanding of nutrients influencing the fetal nervous system's development. Age, place of residence, family status, and professional status did not affect their knowledge. CONCLUSION: Conclusions: The study showed that it is necessary to conduct nutritional education among women of reproductive age. Increasing the respondents' awareness of the importance of nutrients determining the fetus's proper development, both during the reproductive period and during pregnancy, is extremely important.

KNOWLEDGE AND ATTITUDES OF YOUNG PEOPLE IN THE FIELD OF EATING DISORDERS.

OBJECTIVE: The aim: To examine the level of knowledge and attitudes of high school students in the field of eating disorders. PATIENTS AND METHODS: Materials and methods: The study group consisted of students of a randomly selected village school (Jendrzejow) and the municipal school (Siemianowice Slaskie). The study was conducted using an original survey consisting of 10 questions regarding the knowledge and attitudes of respondents towards eating disorders. RESULTS: Results: A total of 313 students (242 female and 71 male) participated in the study. 44.7% of respondents from the village school and 56.6% of respondents from the municipal school were dissatisfied with their appearance; 21.6% and 27.9%, respectively, were currently using the diet. 68% of students from Jedrzejow and 53.3% of students from Siemianowice Slaskie made an attempt to reduce body weight at least once in their lives. 55.1% of the village school respondents and 47.4% of the municipal school respondents noticed the influence of the media on the desire to achieve a slim figure. Girls showed better knowledge about eating disorders than boys (p = 0.008). Over 70% of students of both surveyed high schools believed that people with eating disorders are unable to cope with the disease on their own. Only 6.7% of students of the municipal school and 12.92% of students of the village school gave themselves a very good grade. CONCLUSION: Conclusions: There is a need to educate young people more broadly about eating disorders and the risk factors for their occurrence.

Mean platelet volume is associated with serum 25-hydroxyvitamin D concentrations in patients with stable coronary artery disease.

There is little published data on the association of platelet function and 25(OH)D concentration. We investigated the associations between mean platelet volume (MPV) and 25(OH)D concentration in patients with stable coronary artery disease. Study population was divided into three groups: group 1-25(OH)D < 10 ng/mL (N = 22), group 2-25(OH)D 10-20 ng/mL (N = 42), and group 3-25(OH)D > 20 ng/mL (N = 14). Study groups shared similar demographics. MPV values were the highest in group 1, moderate in group 2, and the lowest in group 3 (11.1 vs 10.4 vs 9.8 fL P < 0.001). There was a negative correlation between MPV and 25(OH)D (R = - 0.38, P = 0.001). ROC analysis demonstrated a moderate predictive value (AUC 0.70) in identifying the discrimination thresholds of MPV (> 10.5 fL) for vitamin D deficiency and a weak predictive value (AUC 0.65) in identifying the discrimination thresholds of 25(OH)D concentration (≤ 15.5 ng/mL) for the presence of large platelets (MPV over the upper limit of normal). In conclusion, even though the effect of vitamin D on platelet size and function is probably multifactorial, our study provides further evidence linking vitamin D to thrombosis and hemostasis. Platelets are another potential element through which vitamin D deficiency could exert adverse cardiovascular outcomes.

The association between occupational lead exposure and serum levels of selected soluble receptors.

The present study was designed to evaluate soluble receptors as potential targets for lead (Pb). Analyses included the serum levels of soluble Vascular Endothelial Growth Factor Receptors 2 (sVEGFR-2), soluble Epidermal Growth Factor Receptor (sEGFR), soluble Human Epidermal Growth Factor 2 (sHER-2/neu), and soluble Interleukin 6 Receptors (sIL-6R) in the groups of chronically and subchronically occupationally exposed workers. The first group consisted of 56 male workers chronically exposed to Pb. The second group (control) comprised 24 male administrative workers. The third group included 36 male workers exposed to Pb for 40 ± 3 days. Examined subjects were employed in the Pb-zinc works to perform periodic maintenance of blast furnaces and production lines. The serum levels of sHER-2/neu and sIL-6R were significantly lower in the group of workers chronically exposed to Pb compared to control values by 45% ( p < 0.05) and 44% ( p < 0.05), respectively. The values of sVEGFR-2 and sEGFR decreased after a subchronic exposure to Pb compared to baseline by 14% ( p < 0.05) and 21% ( p < 0.05), respectively. At the same time, the levels of sIL-6R also decreased by 14% ( p < 0.05). Results of the present study indicated that both chronic and subchronic occupational Pb exposures resulted in decreased levels of several soluble receptors (sVEGFR-2, sEGFR, sHER-2/neu, and sIL-6R), probably due to Pb-induced modulations of the transcription factors and metalloprotease activities, that are necessary for soluble receptor synthesis.

Association between multimorbidity and mean platelet volume in diabetic patients with acute myocardial infarction.

AIMS: Diabetes mellitus (DM) is one of the most frequently detected conditions in multimorbid disease clusters. Platelet activation is one of the key mechanisms underlying atherothrombosis in acute myocardial infarction. Available data link mean platelet volume (MPV) to poor prognosis not only in cardiovascular and non-cardiovascular disease. Given the lack of research data on the association between disease clusters and MPV, we have set out to investigate the link between multimorbidity and MPV in diabetic patients with acute myocardial infarction. METHODS: A total of 277 patients with DM and STEMI undergoing primary percutaneous coronary intervention were enrolled. Based on the number of comorbidities the study population was divided into two groups: group 1 (N = 58) with ≤ 1 comorbidity and group 2 (N = 219) with ≥ 2 comorbidities. A subanalysis was performed within the multimorbidity group: group 2A with two or three comorbidities (N = 156) and group 2B with at least four comorbidities (N = 63). RESULTS: In the study population, 15.9% of patients had one comorbidity, and 22.0, 34.3, and 22.7% of patients had two, three, or at least four comorbid conditions, respectively. Both MPV and PDW were elevated in multimorbid patients (9.3 vs 10.8 fl and 9.5 vs 10.3 fl, respectively). The highest platelet volume indices were observed in patients with at least four comorbid conditions. There was a moderate positive correlation between MPV and the total number of comorbidities, the number of CVD comorbidities, and the number of non-CVD comorbidities. CONCLUSIONS: These findings indicate that multimorbidity is associated with an increase in platelet volume indices. MPV values increased with the increasing number of comorbid conditions. Importantly, MPV values were elevated in some, but not all CVD and non-CVD conditions.

Relationship Between Plasma Pentraxin 3 Concentration and Platelet Indices in Patients With Stable Coronary Artery Disease.

Few reports have analyzed the effect of pentraxin 3 (PTX3) on platelets and their activation. We explored the association between plasma PTX3 and platelet indices. Forty-nine patients with stable coronary artery disease (CAD) were enrolled. Based on median PTX3, the study population was divided into group 1 (n = 25; PTX3 ≤ 0.98 ng/mL) and group 2 (n = 24; PTX3 > 0.98 ng/mL). Platelet indices investigated included mean platelet volume (MPV), platelet distribution width (PDW), platelets and large cell ratio (P-LCR), MPV to platelet count ratio (MPV/PC), platelet to lymphocyte ratio (PLR), and MPV to lymphocyte ratio (MPVLR). Patients with lower PTX3 had a higher lymphocyte count. Platelet count was similar in both groups. Notwithstanding, patients with higher PTX3 concentrations had elevated MPV (8.3 vs 10.0 fL; P < .001) and PDW (9.4 vs 12.4 fL; P < .001). However, the MPV/PC ratio was similar in both groups. Thromboinflammatory biomarkers (PLR, MPVLR) were also elevated in group 2. Pentraxin 3showed a strong, positive correlation with MPV ( r = .75, P < .01) and PDW ( r = .80, P < .01), and weak to moderate correlation with MPVLR. In conclusion, PTX3 is associated with larger platelet size as assessed by platelet volume indices. There is a strong correlation between plasma PTX3 level and MPV and PDW.

Prognostic impact of multimorbidity in patients with type 2 diabetes and ST-elevation myocardial infarction.

INTRODUCTION: There is an increasing body of evidence on the clinical importance of multimorbidity, which is defined as the coexistence of two or more chronic conditions. Type 2 diabetes (T2DM) is one of the most frequent chronic conditions. Most adults with type 2 diabetes have at least 1 coexisting chronic condition and approximately 40% have 3 or more. Prior studies have suggested that cardiovascular (CVD) and non-CVD comorbid conditions yield worse outcomes in patients hospitalized with ST-elevation myocardial infarction (STEMI). It is unclear, however, the extent to which multimorbidity has a cumulative effect on long-term risk. Therefore we have set out to determine the prognostic value of multiple comorbidity on long-term outcomes in this population of patients. METHODS: A total of 277 patients with T2DM and STEMI undergoing primary percutaneous coronary intervention (PCI) were enrolled. Based on the number of comorbidities the study population was divided into two groups: group 1 (N=58) with ≤ 1 comorbidity and group 2 (N=219) with ≥ 2 comorbidities. RESULTS: Comorbid conditions were prevalent among study participants (Figure 1). The median number of comorbidities was three. 15.9% of patients had one comorbidity and 22.0%, 34.3%, and 22.7% of patients had two, three or at least four comorbid conditions respectively. A majority of patients had at least one CVD comorbidity (6.1% of patients had none), whereas 53.1% of patients did not have any non-CVD comorbidity. During hospitalization 3 out of 58 patients (5.2%) died in group 1 and 25 of 219 patients (11.4%) died in group 2. The number of comorbid conditions was not an independent predictor of in-hospital death. During 12-month follow-up, 5 of 58 patients (8.6%) and 42 of 219 patients (19.9%) died, respectively in group 1 and 2 (P=0.05). The number of comorbid conditions proved in ROC analysis that for 12-month mortality, the prognostic value was modest, but for 12-month acute coronary syndromes the prognostic value was good. Increase in the number of comorbid conditions by one was associated with a 15% increase in the relative risk of 12-month mortality and a 41% increase in the relative risk of 12-month acute coronary syndromes (ACS). CONCLUSIONS: Comorbid conditions are highly prevalent among these groups of patients. Majority of patients have at least 2 other cardiovascular comorbidities and one or two non-cardiovascular comorbidities. In terms of long-term follow-up, multimorbidity was associated with worse outcomes. The risk of both long-term mortality and ACS increased with the increasing number of comorbidities. In summary, our findings highlight the importance of indentifying patients with multimorbidity. This, in turn, could allow for provision of better care to these high-risk and complex group of patients.

Platelet-to-lymphocyte ratio predicts contrast-induced acute kidney injury in diabetic patients with ST-elevation myocardial infarction.

AIM: There has been a rise in contrast-induced acute kidney injury (CI-AKI). We examined the role of platelet-to-lymphocyte ratio (PLR) in predicting CI-AKI episodes in patients with myocardial infarction (MI) and diabetes. METHODS: A total of 719 patients with diabetes and MI were enrolled. Study population was divided into: group 1 (n = 615) without CI-AKI and group 2 (n = 104) with CI-AKI. RESULTS: Patients with CI-AKI had higher in-hospital mortality and a longer in-hospital stay. Median PLR was higher in patients with CI-AKI. Receiver operating characteristic analysis indicated PLR to be a good predictive tool in assessing the risk of CI-AKI. PLR was an independent predictor of CI-AKI (OR: 1.22; p < 0.0001). CONCLUSION: These results suggest potential role for PLR as a biomarker of CI-AKI among diabetic patients with MI who undergo percutaneous coronary intervention.

Effects of trimetazidine on interleukin-2 and interleukin-8 concentrations in patients with coronary artery disease.

Trimetazidine (TMZ) exhibits metabolic and cardioprotective effects. The aim of this study was to assess the effects of TMZ on interleukin-2 (IL-2) and interleukin-8 (IL-8) serum concentrations in 156 patients with stable coronary artery disease. They underwent a treadmill exercise test (TET) before and after 3 months of TMZ treatment. IL-2 and IL-8 concentrations were determined before and after each TET. Before treatment, TET did not influence IL-2 concentrations, whereas IL-8 concentrations increased. TMZ treatment led to a decrease in IL-2 concentrations before TET, as well as it prevented the increase of IL-8 following the second TET. Obtained results confirmed the improvement in TET performance during TMZ treatment and they revealed a significant influence of TMZ on IL-2 and IL-8 concentrations both before and after TET. These changes may reflect potential anti-inflammatory effects of TMZ.

Single nucleotide polymorphisms for genes encoding cytokines in the context of cardiac surgery. Part I: Heart transplantation.

Cardiovascular diseases remain the leading cause of death in Poland and other countries of the European Union. Patients with end-stage heart failure constitute a patient subgroup for whom the treatment of choice is heart transplantation. Despite advances in immunosuppressive therapy, acute or chronic graft rejection occurs in 20-30% of cases in the first six months after transplantation. The significance of the immune response and inflammation in graft rejection implies the important role of cytokines. Molecular markers are sought to facilitate risk assessment and improve patient care. At present, genetic tests are not used for this purpose, but studies aiming to rectify that have been conducted for years, including studies on single nucleotide polymorphisms of cytokine genes. This paper presents the results of research on the single nucleotide polymorphisms (SNPs) of the IL-2, IL-4, IL-6, IL-10, TGF-ß1, PDGF, VEGF, and TNF-α genes in conjunction with heart transplantation. The analyzed data do not allow for reliable application of these genetic tests in clinical practice, but suggest that it is a promising direction which may improve the options of treatment individualization in the future.

Triterpenes as potentially cytotoxic compounds.

Triterpenes are compounds of natural origin, which have numerously biological activities: anti-cancer properties, anti-inflammatory, anti-oxidative, anti-viral, anti-bacterial and anti-fungal. These substances can be isolated from plants, animals or fungi. Nowadays, when neoplasms are main cause of death, triterpenes can become an alternative method for treating cancer because of their cytotoxic properties and chemopreventive activities.