Subjective assessment of occupational stress and mental health of nurses during the Covid-19 pandemic period.

Introduction: Health status, sickness absence, and nurses' attrition have a direct impact on the quality of care provided and patients' health outcomes. The Covid-19 pandemic exacerbated issues that existed within the Polish healthcare system prior to the pandemic, including staff shortages, low wages, and system inadequacies. The aim of this study was to investigate how nurses during the Covid-19 pandemic period rated the burdensomeness of job characteristics and their mental health status, as well as the correlations between factors directly caused by the Covid-19 pandemic and nurses' subjective assessments of job characteristics and mental health. Method: The cross-sectional study was conducted in January 2022, in Poland and involved 796 registered nurses working in hospitals. Results: Despite the pandemic's sweeping societal effects, this research finds limited alteration in nurses' perceptions of job stress and self-assessed mental health. Factors such as contact with infected patients, quarantine, and isolation do not appear to substantially modify mental health perceptions among nurses. Intriguingly, nurses subjected to COVID-19 testing report heightened stress and compromised mental health. Conclusion: The interplay of diverse factors influencing the well-being of nurses is intricately complex. It is advisable to prudently execute interventions and strategies to address the pandemic, aiming to alleviate its potential adverse effects on the mental health of nurses.

Tumor Necrosis Factor (TNF) α, Endothelin (ET) 1 and α1-Acid Glycoprotein (AGP) as Potential Urine and Serum Markers of Metabolic Complications in Psoriasis?

INTRODUCTION: Psoriasis, one of the most frequent dermatoses, strongly associated with metabolic disorders which increase patients' comorbidity and mortality. Hence, it is essential to look for markers of such complications. Our aim was to assess the clinical utility of urinary tumor necrosis factor alpha (TNFα), endothelin 1 (ET-1) and α1-acid glycoprotein (α1AGP) as well as their serum concentrations as markers of metabolic complications in psoriatics, and to examine the relations of these markers to clinical and demographic parameters. METHODS: The study involved 60 patients with plaque psoriasis and 30 volunteers without skin diseases (the control group). Serum and urinary concentrations of TNFα, ET-1 and α1AGP were measured by ELISA. Psoriasis severity was assessed using the psoriasis activity and severity index (PASI). Routine laboratory investigations were additionally performed. RESULTS: All serum markers were significantly higher in the patients compared to the controls. TNFα was undetectable in the urine in half of the patients. The urinary ET-1/creatinine concentration ratio was significantly lower in the psoriatics than the controls, whereas the absolute urinary α1AGP was significantly higher and the α1AGP/creatinine ratio was insignificantly different. There was no correlation between serum or urinary markers and PASI. All serum markers were higher in patients with psoriasis lasting less than 15 years. CONCLUSIONS: Serum TNFα, ET-1 and α1AGP seem to be useful biomarkers of metabolic syndrome in psoriatics. ET-1 could perhaps become a urinary marker of metabolic disorders in psoriatics, but further studies are required to confirm that a decreased ET-1 concentration in urine is a reliable predictive tool. Increased urinary α1AGP also requires more in-depth research as a potential marker. TNFα urine assessment does not seem to be useful for screening for metabolic disorders in psoriatics. Serum or urinary TNFα, ET-1 and α1AGP do not seem to be associated with psoriasis severity or duration.

Strategies for Coping With Stress Used by Nurses in Poland and Belarus During the COVID-19 Pandemic.

Introduction: Stress is an inseparable element of nurses' work. It is also the cause of wellbeing disorders and the source of various diseases. The wellbeing and health of nurses has a direct impact on the quality of care and health outcomes for patients. An appropriate stress coping strategy can reduce the impact of stress and mitigate its negative consequences. The COVID-19 pandemic, especially in its initial period, was a source of enormous additional stress for nurses. In Poland and Belarus: two neighboring countries with common history and similar culture, the authorities took a completely different approach to fighting the COVID-19 pandemic. Aim: The purpose of this study was to investigate and compare how nurses in Poland and Belarus cope with stress during the COVID-19 pandemic. Materials and Method: The cross-sectional study was conducted among 284 nurses working in hospital in Bialystok, Poland (158) and in Grodno, Belarus (126). Mini-Cope inventory - the polish adaptation of Carver's BriefCope was used for measuring coping with stress. Results: Only 17.5% of Belarusian nurses were tested for the presence of the virus and only 4.8% were infected, while in Poland it was 50.6 and 31.0%, respectively. The most frequent used coping strategies were active strategies (active coping, planning) and the least-used were avoidance strategies (behavioral disengagement, substance use) in both countries. Polish nurses significantly more often than Belorussian used support-seeking/emotion-oriented strategies, as well as avoidance strategies. No differences were found for active coping strategies between the both groups. Contact with a patient infected with the SARS-CoV2 virus did not influence the choice of stress coping strategies by nurses in both countries. Staying in quarantine or home isolation favored more active coping strategies, especially in the case of Belarusian nurses. Taking a SARS-CoV-2 test did not statistically differentiate the choice of coping strategies in the Belarusian group. In the Polish group, nurses with a positive SARS-CoV-2 test result used both use of instrumental support and use of emotional support strategies less frequently. SARS-CoV-2 virus infection did not statistically differentiated how stressful situations were handled in Polish group. Conclusions: Polish and Belorussian nurses used similar strategies to cope with stress in the face of the COVID-19 pandemic. The social and demographic differences between Polish and Belorussian nurses differentiated the choice of coping strategies among the respondents to a greater extent than the completely different approach of the media and authorities to the COVID-19 pandemic in the two countries. The threat of the COVID-19 pandemic does not affect the choice of stress coping strategies by nurses in Poland and Belarus. Being in quarantine or home isolation favored the use of active coping strategies among Belorussian nurses. Polish nurses, on the other hand, were more likely to turn to religion after being quarantined.

Neurobehavioral effects of uremic toxin-indoxyl sulfate in the rat model.

Chronic kidney disease (CKD) is deemed to be a worldwide health concern connected with neurological manifestations. The etiology of central nervous system (CNS) disorders in CKD is still not fully understood, however particular attention is currently being paid to the impact of accumulated toxins. Indoxyl sulfate (IS) is one of the most potent uremic toxins. The purpose of the present study was to assess IS concentrations in the cerebellum, brainstem, cortex, hypothalamus, and striatum with hippocampus of rats chronically exposed to IS. To evaluate IS impact on neurochemical and behavioral alterations, we examined its influence on brain levels of norepinephrine, epinephrine, dopamine, serotonin and their metabolites, as well as changes in behavioral tests (open field test, elevated plus maze test, chimney test, T maze test, and splash test). Our results show the highest IS accumulation in the brainstem. IS leads to behavioral alterations involving apathetic behavior, increased stress sensitivity, and reduced locomotor and exploratory activity. Besides, IS contributes to the impairment of spatial memory and motor coordination. Furthermore, we observed reduced levels of norepinephrine, dopamine or serotonin, mainly in the brainstem. Our findings indicate that IS can be one of the crucial uremic factors responsible for altered mental status in CKD.

Oxidative Storm Induced by Tryptophan Metabolites: Missing Link between Atherosclerosis and Chronic Kidney Disease.

Chronic kidney disease (CKD) occurrence is rising all over the world. Its presence is associated with an increased risk of premature death from cardiovascular disease (CVD). Several explanations of this link have been put forward. It is known that in renal failure, an array of metabolites cannot be excreted, and they accumulate in the organism. Among them, some are metabolites of tryptophan (TRP), such as indoxyl sulfate and kynurenine. Scientists have become interested in them in the context of inducing vascular damage in the course of chronic kidney impairment. Experimental evidence suggests the involvement of TRP metabolites in the progression of chronic kidney disease and atherosclerosis separately and point to oxidative stress generation as one of the main mechanisms that is responsible for worsening those states. Since it is known that blood levels of those metabolites increase significantly in renal failure and that they generate reactive oxygen species (ROS), which lead to endothelial injury, it is reasonable to suspect that products of TRP metabolism are the missing link in frequently occurring atherosclerosis in CKD patients. This review focuses on reports that shed a light on TRP metabolites as contributing factors to vascular damage in the progression of impaired kidney function.

Erythropoietin Enhances the Cytotoxic Effect of Hydrogen Peroxide on Colon Cancer Cells.

BACKGROUND: Cancer patients treated with alkylating agents and radiotherapy are exposed to high level of reactive oxygen species (ROS) in tissues. ROS can involve superoxide free radicals, peroxynitrite, singlet oxygen, nitric oxide and hydrogen peroxide. It is well documented that increased exposure to oxygen through a high metabolic rate could lead to a shortened life span. Ionizing radiation, use of drugs and the development of cancer can lead to cancer-induced anemia. Recombinant human erythropoietin (Epo) supplementation is one of the methods for treating anemia. Erythropoietin through an increase in the number of erythrocytes, improves oxygenation tissue. The aim of this work was to study the effect of Epo on colon adenocarcinoma cells (DLD-1) given alone or in combination with hydrogen peroxide (H2O2). Cell proliferation and number were measured. METHODS: Expression of EpoR, Bcl-2 and Akt1 protein was assessed by RT-PCR, Western blot, and confocal microscopy. RESULTS: The results show that the coadministration of Epo and H2O2 indicates antitumor action, which occurs via a dose-dependent inhibition of DLD-1 cell growth and proliferation. Moreover, the coadministration of Epo and H2O2 resulted in a decrease of cell numbers, as well as Bcl-2 expression. The incubation of DLD-1 cells with those agents led to a decrease in EpoR and phosphorylated EpoR expression and an increase in Akt1 and phosphorylated Akt expression. The addition of Epo to H2O2 intensified the cytotoxic effect of the latter. CONCLUSION: These preclinical results suggest that Epo during chemotherapy or radiotherapy may possess potential benefits in colon cancer patients.

Pharmacokinetics and pharmacodynamics of aliskiren, an oral direct renin inhibitor.

Intensive efforts have been spent to discover therapeutic, non-peptide and orally effective hypertensive drugs. One drug that emerged from this effort is aliskiren, a direct human renin inhibitor that blocks the conversion of angiotensinogen to angiotensin I (Ang I). In contrast to other antihypertensive agents, aliskiren decreases plasma renin activity (PRA). In healthy human subjects, doses of between 40 and 640 mg of aliskiren exert a dose-dependent reduction in PRA and Ang I and Ang II levels. The bioavailability of aliskiren is low (2%), peak plasma concentrations are reached within one to three hours and the binding with plasma proteins achieves approximately 47-51%. Aliskiren is slightly metabolized (20%) by CYP3A4. The most common adverse events include diarrhea, headache, back pain and gastrointestinal disorders. Aliskiren is well tolerated, and may be used alone or in combination with other antihypertensive agents. Aliskiren belongs to a new class of agents that effectively and specifically inhibit the RAS. This drug functions through a novel mechanism of action and has the potential to become a true alternative to angiotensin converting enzyme inhibitors and angiotensin receptor blockers in the therapy of hypertension and other cardiovascular and renal disorders.

N-methylnicotinamide failed to induce endothelial prostacyclin release in perfused rat hindquarters.

N-methylnicotinamide, a nicotinamide derivative, possesses anti-thrombotic activity, although the mechanism of its action is unclear. Using a rat model of isolated perfused hindlimb, we tested whether this metabolite of nicotinamide is able to inhibit the vasoconstrictive effects of epinephrine, norepinephrine, and angiotensin II, thereby releasing prostacyclin from the endothelium. We found that N-methylnicotinamide administration by infusion or bolus injection did not change the course of perfusion pressure and did not inhibit the vasoconstrictive action of epinephrine, norepinephrine, or angiotensin II. In contrast, prazosin was able to completely abolish the constriction induced by epinephrine. Moreover, we did not find any changes in the level of a stable prostacyclin analog measured in the collected perfusate samples. Thus, we did not observe any endothelial prostacyclin-releasing properties of N-methylnicotinamide in the perfused rat hindquarters model.