Multiple sclerosis susceptibility may be associated with the coding rs20541 (R130Q) IL-13 gene polymorphism in the Polish population.

Some of the multiple autoimmune diseases have been already associated with IL-13 single-nucleotide polymorphisms (SNPs). However, there are only few studies regarding multiple sclerosis (MS) risk and IL-13 rs20541 (R130Q) polymorphism, and their results are conflicting. Therefore, the aim of our study was to investigate the frequency of the IL-13 gene rs20541 (R130Q) polymorphism in MS participants and its association with MS clinical subsets in the Polish population. We conducted a case‒control study including 94 relapsing remitting MS patients and 160 healthy volunteers. We genotyped the rs20541 polymorphism in the IL-13 gene and analysed the genotype frequency, age of MS onset and clinical condition (EDSS values) of the MS participants. Fisher's exact test was used for statistical analysis, and the log-linear model was applied to test for associations. Allele A, as well as the AA and AG genotypes, was observed to be significantly more common in the MS subjects. The OR (odds ratio) for the A compared to the G allele was 1.71 (1.14-2.56), whereas OR 2.33 (0.86-6.26) and OR 1.92 (1.11-3.30) were obtained for the AA and AG genotypes, respectively. We did not identify any significant associations of the studied IL-13 SNP with the investigated clinical parameters of the MS participants. Our results suggest that the rs20541 polymorphism in the IL-13 gene may play an important role in MS predisposition but not in investigated clinical parameters in MS subjects of the Polish population.

Psychosocial Burden and Quality of Life of Surveyed Nurses during the SARS-CoV-2 Pandemic.

This study analyzes the impact of occupational burnout on the quality of life (QOL) of nurses surveyed during the SARS-CoV-2 pandemic. A total of 668 active nurses employed in public hospitals in Podkarpackie voivodeship (Poland) were surveyed. Throughout the pandemic, all wards where responders worked had a division into so-called "clean" and "dirty" zones, as well as balanced working hours. The research used the authors' survey questionnaire Maslach Burnout Inventory (MBI) and the Polish version of the World Health Organization Quality of Life Instrument Short Form (WHOQOL-BREF). Descriptive statistics were used in the analysis of the collected material, while correlations between ordinal or quantitative variables were made using Spearman's-rho coefficient. According to 94.0% of respondents, stress is an integral part of the nursing profession. The mean of the respondents' MBI burnout was 50.83 +/- 9.05 pts. The respondents' overall quality of life also averaged 65.74 +/- 13.12 pts. There were negative statistically significant correlations between the MBI and BREF domains, most of which were characterized by clear strengths of association. Higher exhaustion in various occupational aspects is associated with poorer quality of life in individual domains.

Stress and Occupational Burnout of Nurses Working with COVID-19 Patients.

COVID-19 pandemic brings many challenges to the daily work of nurses. While carrying out professional tasks for patients infected with the SARS-CoV-2 virus, nurses experience tremendous psychological pressure due to their workload in a high-risk environment. This causes severe stress and leads to occupational burnout. The purpose of this study was to assess the level of stress and occupational burnout among surveyed nurses working with patients with COVID-19. A total of 118 nurses working with patients infected with SARS-CoV-2 virus participated in the study. Among the respondents, there were 94.9% women and 5.1% men. The average age of the respondents was 38.1 +/- 2.1. The survey was conducted between April and May 2022. The research tool was a survey questionnaire, consisting of three parts: sociodemographic data and self-administered survey questionnaire containing questions about the specifics of working with COVID-19 patients. The third part was a standardized tool: the MBI Burnout Questionnaire by Christina Maslach. Participation in the study was anonymous and voluntary. Statistical analysis for independence of variables used the Chi-square test. On the other hand, coefficients based on the Phi test and Kramer's V test, as well as non-parametric Mann-Whitney U-test (for 2 samples) and Kruskal-Wallis test (for more than 2 samples) were used to determine the strength of the relationship. During these analyses, in addition to standard statistical significance, the corresponding "p" values were calculated using the Monte Carlo method. The results obtained allow us to conclude that surveyed nurses working with COVID-19 patients are exposed to various stressors leading to occupational burnout. The vast majority of respondents, i.e., 90.7%, believe that stress is an integral part of the nursing profession and the average of MBI burnout among respondents was 55.67 +/- 9.77 pts., emotional exhaustion 24.74 +/- 6.11, depersonalization 12.42 +/- 2.99 and a sense of personal achievement 18.52 +/- 4.50 which means that only slightly more than half of the nurses surveyed noticed symptoms of occupational burnout themselves. The research has revealed that working with a patient who is positive for COVID-19 is a cause of stress and is related to experiencing symptoms of burnout in the group of surveyed nurses.

Quality of Life of Patients with Arterial Hypertension.

Symptoms of hypertension with accompanying complications result in a significant reduction in patients' quality of life. Effective conduct of prescribed pharmacotherapy supported by a healthy lifestyle allows to achieve satisfactory effects of treatment, which translates into an improvement in the quality of life of patients. The aim of the work was to determine the quality of life of patients with hypertension and the factors affecting it. The study included 100 people with hypertension, who are patients of the department of internal diseases of the hospital in Hajnówka during the period 1.6.2019-1.12.2019. The questionnaire survey, the standardized WHO Quality of Life (WHOQOL)-BREF scale and the Barthel scale were the research tools. The probability p < 0.05 was assumed as the level of statistical significance. The study group consisted of subjects between 30-89 years old. The majority were men and those living in the city. The average BMI (body mass index) of the subjects was 28.4 kg/m2. The duration of the disease among those surveyed was on average 7 ± 6.34 years. The highest-rated area of quality of life was the physical field and the lowest social sphere according to the WHOQOL-BREF questionnaire. Patients with hypertension have determined their quality of life at a good or medium level in the physical, psychological, social, and environmental sphere. There are many factors that improve quality of life in all areas. These include following the recommendations on modifiable risk factors.

Prevalence of multiple sclerosis in Poland.

OBJECTIVE: The prevalence of multiple sclerosis (MS)was previously unknown in Poland. The aim of this study was to determine the prevalence of MS in Poland. METHODS: MS prevalence was determined on the basis of data from the Swietokrzyskie (central Poland) and Podlaskie (northeastern Poland) Voivodeships. The area population on the prevalence study day (December 31, 2013) was 1,268,239 (649,007 women; 619,232 men) in central and 1,195,625 (612,979 women; 582,646 men) in northeastern Poland. RESULTS: The overall crude prevalence rate of confirmed MS patients was 109.1/100,000 (95% confidence interval[CI]103.5-115.0) in the Swietokrzyskie and 108.7/100,000 (95% CI 103.0-114.7) in the Podlaskie Voivodeships. A significantly higher prevalence was recorded in females (149.8/100,000, 95% CI 140.6-159.3 vs. 142.4/100,000, 95% CI 133.3-152.0) than in males (66.5/100,000, 95% CI 60.4-73.1 vs.57.8/100,000, 95% CI 52.0-64.2)(p < 0.001). Age-adjusted rates for the Polish Standard Population were the same in both regions (110.3/100,000 (95% CI 104.6-116.1) vs.110.9/100,000 (95% CI 105.1-117.1)) and for the European Standard Population did not different statistically between both voivodeships (103.9/100,000 (95% CI 98.6-109.5) vs.108.5/100,000 (95% CI 102.7-114.5)). CONCLUSION: This is the first data that obtained the level of MS prevalence in Poland and confirmed that Poland is a high-risk area for multiple sclerosis.

Hyperglycemia and diabetes have different impacts on outcome of ischemic and hemorrhagic stroke.

INTRODUCTION: Stroke is the second leading cause of long-term disability and death worldwide. Diabetes and hyperglycemia may impact the outcome of stroke. We examined the impact of hyperglycemia and diabetes on in-hospital death among ischemic and hemorrhagic stroke patients. MATERIAL AND METHODS: Data from 766 consecutive patients with ischemic (83.15%) and hemorrhagic stroke were analyzed. Patients were classified into four groups: ischemic and diabetic; ischemic and non-diabetic; hemorrhagic and diabetic; and hemorrhagic and non-diabetic. Serum glucose was measured on admission at the emergency department together with biochemical and clinical parameters. RESULTS: Mean admission glucose in ischemic stroke patients with diabetes was higher than in non-diabetic ones (p < 0.001) and in hemorrhagic stroke patients with diabetes than in those without diabetes (p < 0.05). Mean admission glucose in all patients who died was significantly higher than in patients who survived. In multivariate analysis, the risk factors for outcome in patients with ischemic stroke and without diabetes were age, admission glucose level and estimated glomerular filtration rate (eGFR), while in diabetics they were female gender, admission glucose level, and eGFR; in patients with hemorrhagic stroke and without diabetes they were age and admission glucose levels. The cut-off value in predicting death in patients with ischemic stroke and without diabetes was above 113.5 mg/dl, while in diabetics it was above 210.5 mg/dl. CONCLUSIONS: Hyperglycemia on admission is associated with worsened clinical outcome and increased risk of in-hospital death in ischemic and hemorrhagic stroke patients. Diabetes increased the risk of in-hospital death in hemorrhagic stroke patients, but not in ischemic ones.

Renal Function Predicts Outcomes in Patients with Ischaemic Stroke and Haemorrhagic Stroke.

BACKGROUND/AIMS: We evaluated renal function and the impact of renal function on in-hospital outcomes in patients with ischaemic and haemorrhagic stroke. METHODS: We collected data from 766 patients with stroke; 637 (83.2 %) with ischaemic and 129 with haemorrhagic one. RESULTS: The mean serum creatinine on admission in patients with both types of stroke, who died, was significantly higher than in those who survived. Multivariate analysis showed that independent predictors of mortality in patients with ischaemic stroke were: ischemic heart disease or prior myocardial infarction, diabetes, admission glucose and eGFR on admission. Also, multivariate analysis showed that independent predictors of mortality in patients with haemorrhagic stroke were: age and admission glucose. CONCLUSIONS: Patients with haemorrhagic stroke, in particular with acute kidney injury during hospitalisation had significantly worse outcomes than patients with ischaemic stroke. Assessment of kidney function is prerequisite to employ the necessary measures to decrease the risk of in-hospital mortality among patients with acute stroke. Appropriate approach to patients with renal dysfunction (adequate hydration, avoidance of nephrotoxic drugs, drug dose adjustment etc) should be considered as preventive and therapeutic strategies in the management of acute stroke.

[Acute kidney injury in patients with acute respiratory distress]. / Ostre uszkodzenie nerek wsród pacjentów z ostra niewydolnoscia oddechowa.

Acute respiratory distress together with hypoxia could be an indication for admission to intensive care unit. It may also lead to acute kidney injury. In addition, mechanical ventilation may be an additional factor for development of acute kidney injury. The aim of the work was to assess the prevalence of acute kidney injury, including the need for renal replacement therapy in patients with acute respiratory distress treated in intensive care unit. In addition, the effect of acute kidney injury on outcome of patients with acute respiratory distress was evaluated. The studies were performed on 100 patients with acute respiratory distress treated in intensive care unit of the regional hospital. Patients were divided into 2 groups in respect to the presence or absence of acute kidney injury. Acute kidney injury was diagnosed in 22% of patients with acute respiratory distress, while 12% required renal replacement therapy, it was more often observed in patients with estimated GFR < 60 ml/min/1.73m2. Length of stay was similar irrespective of kidney function, however, the mortality was significantly higher in patients with eGFR < 60 ml/min/1.73 m2, particularly in those on hemodialyses. In addition, mortality was associated with older age and sepsis.