Bioethics Committee Research Articles

CLINICAL COURSE OF OBESITY-ASSOCIATED ASTHMA DEPENDING ON THE GLN27GLU POLYMORPHIC VARIANT OF THE β2-ADRENORECEPTOR GENE, TAKING INTO ACCOUNT THE AGE OF ONSET

Introduction. Studies have shown that bronchial asthma (BA) associated with obesity has a more severe course, lower control, more frequent cases of low efficacy of basic treatment, and exacerbations. Two phenotypes have been distinguished in BA-obesity comorbidity based on age of onset: early atopic and late non-atopic. It is known that genetic factors associated with β2-adrenoceptor (AR) genes are important in the development of both asthma and obesity.
 The purpose of the study aimed to analyze the association of the Gln27Glu polymorphism of the β2-adrenoceptor gene with the severity of the course of bronchial asthma with obesity, taking into account the age of its onset.
 Research material and methods. 195 asthma patients with obesity consented for the study participation were examined. The control group consisted of 95 practically healthy people. Patients were divided into two clinical groups depending on the age of onset of BA: the first group included 100 patients with an early onset, the second group - 95 patients with a late onset. The diagnosis and treatment of asthma followed the guidelines of the Global Initiative for Asthma (2016) and its updated versions. The study was approved by the Bioethics Commission of the Educational and Scientific Medical Institute of Sumy State University. Determination of the Gln27Glu polymorphism of the β2-AR gene (rs1042714) was performed using the polymerase chain reaction with the subsequent analysis of restriction fragments. Statistical analysis of the obtained results was carried out using the SPSS-17 program. Pearson's chi-squared test was used to compare genotype distributions between experimental groups. To determine the risk of BA and obesity, odds ratios and 95% confidence intervals were calculated for dominant, recessive, superdominant, and additive models of inheritance. Their relevance was assessed using the Akaike information criterion. All tests were two-sided, and values p < 0.05 were considered statistically significant.
 Research results. The frequency of Gln/Gln, Gln/Glu and Glu/Glu genotypes according to the Gln27Glu polymorphism of the β2-AR gene in patients with early-onset obesity-associated asthma was 70.0; 25.0; 5.0% with a mild course and 55.0; 36.2; 8.8% with severe (χ2 = 1.49; p = 0.473); and with a late debut - 50.0; 43.8; 6.2% with mild and 54.0%; 31.7; 14.3%, respectively, with severe (χ2 = 2.10; p = 0.350). Despite the absence of a probable difference in the distribution of genotypes depending on the severity of the course, it was found that the frequency of homozygotes for the minor allele was 1.8 times higher in patients with a severe course of early BA and 2.3 times higher in late BA compared to that in patients with mild BA course.
 The risk of early-onset BA with obesity and a severe course showed no association in all models of inheritance, and in patients with late-onset BA, there was a 1.66-fold increase (95% CI (1.03 – 2.72), p = 0.04) in the additive inheritance model (p = 0.04).
 Conclusions. There are no statistically significant differences in the distribution of genotypes according to the Gln27Glu polymorphism of the β2-AR gene depending on the severity of the course of early and late BA with obesity. The risk of developing a severe course of early BA did not depend on the Gln27Glu polymorphism of the β2-AR gene, and late BA increased by 1.66 times in the additive model of inheritance.

Bioethics-CSR Divide

Bioethics-CSR Divide

Effectiveness of early pharmaceutical interventions in symptomatic COVID-19 patients: A randomized clinical trial.

We assessed the effectiveness of oral Hydroxychloroquine (HC), Azithromycin (AZ) and Oseltamivir (OS), alone or combined, among patients hospitalized with mildly symptomatic coronavirus infectious disease (COVID-19). Following the approval of the National Bioethics Committee and prospective registration (clinicaltrials.gov NCT04338698), a multicenter randomized clinical trial of adaptive design was conducted at 10 multispecialty hospitals in Pakistan. Patients were randomized into seven treatment groups. Starting April 15, 2020, consenting, eligible, otherwise healthy adult patients or those with co-morbidities under control, were recruited if they presented with mildly symptomatic COVID-19 (scored 3 on a 7-point ordinal scale anchored between 1 = not hospitalized, able to undertake normal activities, to 7 = death) confirmed by quantitative Real-Time Polymerase Chain Reaction (qRT-PCR). Two primary outcomes were assessed by day seven: Turning qRT-PCR negative; and clinical improvement of two points from the baseline. Outcome rates were compared using a chi-square test. Multiple imputations were applied to handle missing data. An interim data analysis was carried out on July 19, 2020, following which the study continued without treatment group changes. Data Safety and Monitoring Board advised to stop recruitment due to its futility on January 18, 2021. Of 471 patients randomized, a total of 426 (90.4%) completed the follow-up for primary outcomes. Based on imputed data analyses at day seven: Total qRT-PCR negative cases were 137/471 (29%, 95% CI 25.0 - 33.4). By day seven, a total of 111/471 (23.5%, 95% CI 19.8 - 27.6) showed clinical improvement. No serious or non-serious adverse event was reported. Among patients with mild COVID-19, there was no statistically significant difference in the effectiveness of oral antimalarial, antiviral, or antibiotic treatments.Clinicaltrials.gov ID: NCT04338698.

The results of an experimental toxicological assessment of the pharmaceutical substance ambroxol hydrochloride, justification of the maximum permissible content in the air of the working area

Introduction. Ambroxol hydrochloride is a biologically active substance used as a pharmaceutical substance in the manufacture of medicines for secretolytic therapy in the case of acute and chronic bronchopulmonary diseases. To date, there is no hygienic standard for the safe content of substances in the air of the working area in the republic.
 The study aims to substantiate and develop the maximum permissible concentrations and hazard class of the pharmaceutical substance ambroxol hydrochloride in the air of the working area.
 Materials and methods. The authors have conducted experimental toxicological studies of the pharmaceutical substance on animals (rats, mice, rabbits) in accordance with the requirements of technical regulatory legal acts and recommendations of methodological documents regulating the justification of hygienic standards.
 Results. Scientists have found that the pharmaceutical substance ambroxol hydrochloride, when injected into the stomach and inhaled, is classified as a low-hazard substance at an average lethal dose/concentration (according to GOST 12.1.007-76), has a mild irritant effect on the skin and moderate on the mucous membranes of the eyes, does not exhibit a skin-resorptive effect, is characterized by a weak cumulative effect and does not it has sensitizing activity. Under the conditions of inhalation of the substance into the body of laboratory animals (rats), the threshold values of acute and chronic harmful effects of this pharmaceutical substance were at the level of 90 mg/m3 (in terms of the effect on the functional state of the nervous activity of rats) and 30 mg/m3, respectively (in terms of changes in behavioral indicators, weight and mass coefficient spleen, blood glucose, alanine aminotransferases and urea) accordingly.
 Conclusion. Based on the experimental results of the toxicological assessment, the authors have justified the standard of permissible content of the pharmaceutical substance ambroxol hydrochloride in the air of the working area at the level of 4.0 mg/m3, they also have established the hazard class of the substance according to GOST 12.1.007-76 (class 3, medium-hazard substances).
 Ethics. The Bioethics Commission of the State Enterprise "SPCH” has approved the use of laboratory animals for experimental purposes (Protocol No. 1 dated 03/04/2020). The treatment of animals was in accordance with the provisions of Directive 2010/63/EU of the European Parliament and of the Council of the European Union of September 22, 2010 on the protection of animals used for scientific purposes.

Validation of the inventory: lockdown and its impact on the university Community

BackgroundSignificant consequences of COVID-19 within academic/professional life are, at the psychological level, related to worry, tension, stress; coping strategies and lifestyle changes. This study describes the process of design and validation of an inventory (QPIC), which aims to assess the psychological impact that a situation of confinement can produce among university students and teachers.MethodsDesign of the instrument and psychometric tests. A sample of 862 students and 229 professors affiliated to Spanish and Colombian universities was used. Data were collected in April 2020 with the request of the favourable Bioethics Committee IR/2020.ResultsSix experts carried out the content validation. A confirmatory factor analysis of the theoretical dimensions proposed for the scales was performed and the internal consistency of each of the three initial scales was confirmed (0.866, 0.813 and 0.834).ConclusionA rigorous and reliable instrument is achieved, consisting of two final scales: (a) Worry, tension and stress scale (b) Coping scale, which helps to measure individual psychological effects in housebound situations. It is an instrument designed, constructed ad hoc to assess the impact of confinement and subjected to validation. The factor structure and reliability of the instrument are examined and good psychometric properties are obtained. The application of this inventory will make it possible to assess the impact on people’s mental health during a period of confinement.

Realist evaluation of maternity waiting home intervention models in Inhambane, Mozambique: protocol for a comparative embedded case study, the Mozambique-Canada Maternal Health Project

IntroductionThis is a study protocol that tests and refines realist theories regarding the uptake and scale-up of the linked maternity waiting home (hereafter MWH) and facility birth intervention in the...

Unveiling the Surge: A Comprehensive Analysis of E-Scooter-Related Injuries at an Urban Level 1 Trauma Center in Vilnius, Lithuania (2018-2021).

Background The surge in electric scooter (e-scooter) adoption in 2019 fueled by sharing platforms has raised safety concerns, leading to an increased incidence of e-scooter-related injuries. Despite regulatory efforts, there has been a notable rise in accidents, prompting a comprehensive investigation. This study conducted at the Republican Vilnius University Hospital (RVUH), a level 1 trauma center, is one of thefirst in the Baltic States aiming to analyze the causes, severity, and frequency of e-scooter injuries from 2018 to 2021. This research addresses a critical gap in understanding e-scooter safety in the Baltic States, providing valuable insights for informed policy and preventive measures. Methodology This retrospective study analyzed e-scooter-related injuries in Vilnius, Lithuania, from April to September during 2018-2021. Data from the RVUH emergency department were examined. Using keywords such as "scooter" and "electric," relevant cases were extracted from the RVUH electronic health system. Included were individuals, both riders and pedestrians, with clear e-scooter involvement, excluding duplicates, those under 18, and users of other types of scooters. Extracted medical records provided data on demographics, injury specifics, helmet use, alcohol consumption, and more. Trauma severity was assessed through the New Injury Severity Score (NISS) and Abbreviated Injury Scale (AIS). Statistical analysis utilized GraphPad Prism software and Excel, adhering to ethical guidelines with RVUH Bioethics Committee approval. Results Over four years, 1,036 e-scooter-related injuries at RVUH revealed a gender-based shift, with males sustaining more injuries. The introduction of rentals in 2019 triggered a 334% surge in injuries compared to 2018. Despite an annual 208% increase from 2018 to 2021, 2021 saw a 710.93% rise. Trauma severity remained consistent, with AIS scores 1 and 2 being prevalent. Non-helmet wearers constituted 97.97%, and soft tissue damage was predominant. Ownership patterns shifted toward rentals (81.15%), reflecting the popularity of sharing platforms. Alcohol influence showed no significant change, but intoxicated patients had a higher surgery rate during four years. Mechanism analysis highlighted tripping as the primary cause. Injury characteristics revealed fractures in 34.56% of cases, primarily affecting upper limbs (53.35%). Soft tissue trauma was prominent (65.44%), with lower limbs being significantly impacted. Conclusions The surge in e-scooter injuries demands urgent preventive action. While most injuries are mild, a significant proportion is moderate to severe, even fatal. Inadequate education, lax enforcement, and uneven infrastructure contribute to the risk. Urgent measures, including road maintenance, speed reduction, and mandatory helmet use, are crucial. Clarity in government directives for designated e-scooter areas is vital. Further research is needed to understand the broader impact of informed policymaking and safer urban mobility. Expanding research to other Lithuanian regions would enhance the current study.

Occupational conditionality of integral hematological indices in metallurgical production workers

The health of the working population is one of the main guarantors of the sustainable and planned development of the state's economy, while working conditions and factors of the production environment play an important role in its formation. Studies of indicators of endogenous intoxication make it possible to identify the formation of adaptive and compensatory changes in the hemogram depending on the conditions of the production environment and the labor 
 process.
 The study aims to explore the degree of professional conditionality of integral hematological indices for early diagnosis of the harmful effects of production factors on the body of workers employed in metallurgy.
 The authors have analyzed the results of some integral hematological indices and carried out the assessment of occupational risk in accordance with the "Temporary methodological recommendations for the calculation of occupational risk indicators" (2005) and the methodological recommendations "Methodology for the detection of occupational diseases and diseases related to working conditions" based on the calculation of relative risk (RR, units) and etiological proportion (EF, %).
 The calculation of the leukocyte intoxication index showed high values in all occupational groups from 50.00% for electricians and gas welders to 88.16% for potash workers. Scientists diagnosed a significantly increased number of eosinophilic granulocytes (more than 5%) in 26.09% of draggers, in 34.52% of rope-winding machinists, in 38.16% of potters compared with the control group (p<0.001). Scientists determined the most pronounced changes in the indicators of endogenous intoxication in the first five years of contact with harmful factors of production. We found high LII values in 62.16% of draggers, 75.00% of compressor unit drivers, 73.53% of rope winding drivers and 45.00% of electricians. The content of eosinophils in peripheral blood, as well as the calculated allergization index, demonstrate almost complete industrial conditionality in all occupational groups of the examined (RR>5, EF=81–100%). In the group of electricians, these indicators have a very high degree of production conditionality.
 Timely identification of workers with violations of integral hematological indices in the dynamics of professional activity allows them to be identified as a risk group for further monitoring and preventive measures.
 Limitations. The conducted study took into account the influence of only harmful production factors on deviations of integral hematological indices in workers of metallurgical production.
 Ethics. The material of the article was approved by the Bioethical Commission at the Ufa Research Institute of Occupational Medicine and Human Ecology (Protocol No. 01-11 dated 11/22/2023).

Prolonged Remission Induced by FENofibrate in children with newly diagnosed type 1 diabetes (PRIFEN): protocol of a randomised controlled trial

IntroductionSphingolipids regulate proinsulin folding, insulin secretion and control beta cells apoptosis. Recent evidence has demonstrated that, among other factors, reduced amounts of sulfatide may be relevant in the development of...

한국 DTC 유전자검사 규제의 추이와 특성

This study aims to uncover the institutional roots of the recent increase in permissible items for DTC genetic testing in Korea. The shift from strict regulations on DTC institutions to a permissive approach began with the 2015 legal amendment, departing from the previous trend set by the National Bioethics Committee after the 2005 Bioethics and Biosafety Act. The research methodology involved a thorough examination of various sources, including annual reports from the National Bioethics Committee, parliamentary proceedings, Ministry of Health and Welfare press releases, and reports from the medical and DTC sectors. The findings indicate that the 2015 legal amendment was led by the Ministry of Health and Welfare, reflecting the demands of DTC institutions more than the medical community. Also, the amendment allowed testing in the ‘disease prevention’ area, traditionally seen as a medical procedure, and permitted testing for items prohibited by presidential decree. To address future challenges, a reassessment of the National Bioethics Committee's composition and role is necessary.

P158 Expression of IL-19 and IL-24 in intestinal mucosa of inflammatory bowel disease: An immunohistochemical study

Abstract Background Interleukins are considered as targets for future inflammatory bowel disease ( IBD) treatments. IL-19 and IL-24 are members of IL-10 family and through the JAK-STAT pathway induce proinflammatory cytokine production. A retrospective single center study was performed to study the IL-19 and IL-24 expression in 121 patients with moderate to severe IBD, before and after treatment with biologics. Methods A retrospective study of 121 patients with moderate to severe IBD was performed using immunochemistry between 1999 and 2017. This study included 72 patients with Crohn's disease (CD), 49 with Ulcerative Colitis (UC) and 20 healthy controls. The age, gender, disease extent, severity and treatment choice were recorded. Endoscopy reports before and after 12 months of treatment were retrieved. Intestinal biopsy samples were retrieved from the Histopathology Lab before and 1 year after treatment with biologics. A signed consent was received from all the patients involved and the study was approved by the Bioethics Committee of Aristotle University of Thessaloniki. The histological specimen were stained for IL-19 and IL-24 before and one year after treatment with biologics. The results were analysed using SPSS for each of the IBD groups (CD, UC) and further to subgroups depending the biologic treatment they received, anti-Tumor Necrosis Factor alpha(anti-TNFa), Vedolizumab (VDZ), Ustekinumab (USK). Results A statistically significant increase was found in IL-19 and IL-24 patients in IBD patients versus healthy controls (P<0.05). On the biologics treated group and the anti-TNFa subgroup, there was statistically significant increase in IL-24 expression post treatment (P<0.01). In UC patients, the IL-24 expression was significantly increased after a successful treatment in relation with Mayo score ( P<0.01). On the CD group, a reverse statistically significant correlation was found between the pre-treatment IL-19 expression and the Harvey Bradshaw Index (H.B.I.) score reduction in the anti-TNFa and the VDZ subgroups (p<0.05). Conclusion A possibly proinflammatory role of IL-19 was found on the CD group. This can be used as a tool in the future to assess the disease activity and support the diagnosis as a diagnostic biomarker, as IL-19 was found normal in healthy controls. An anti-inflammatory role of IL-24 was found especially in the UC group and in relation with the activity index score post-treatment. This can be used potentially as a marker of response to treatment in active UC, assisting the clinical management. Further research is needed to delineate the exact role of these interleukins in intestinal inflammation.

Sociocultural understanding of Tuberculosis and implications for care-seeking among adults in the province of Zambezia, Mozambique: Qualitative research.

Mozambique has a high burden of Tuberculosis (TB) with an incidence of 368 per 100,000 population in 2020, coupled with a low all-form TB detection rate. The COVID-19 pandemic has exacerbated delays in timely diagnosis and treatment of new TB cases. Promoting active TB case finding is a national priority in Mozambique. We conducted qualitative research to explore factors influencing TB testing in Zambezia province in Mozambique. One-to-one, semi-structured, audio-recorded telephone interviews were conducted to explore TB-related knowledge, and barriers and facilitators to TB testing. A sample of two TB Program staff, two community providers of TB services, and 19 community members (10 women and 9 men) was recruited, with support from provincial government TB staff, from four districts in Zambezia with a high TB burden. Interviews were transcribed verbatim, and thematic analysis was conducted. The Mozambican National Bioethics Committee for Health approved the study protocol. Our study highlights that knowledge about TB symptoms and its causes is low, which could delay timely TB testing. Sociocultural beliefs often implicate certain types of sexual activity and women as causes of TB symptoms; for example, having sex with a widow who has not been traditionally purified, or with a woman who has had an abortion. Therefore, people usually tend to first seek care from traditional healers instead of going to a health facility. Additionally, stigma associated with HIV and TB also delays care seeking. Gender-related disparities in TB care seeking were also evident. This study provides valuable insights into how healthcare seeking for TB is influenced by sociocultural understanding of symptoms and gender dynamics. Therefore, interventions to promote timely and appropriate care seeking for TB should be contextually tailored, culturally appropriate, and gender sensitive.

The Psychosomatic Health Status of Polish Psychiatric Nurses in Relation to Socio-Demographic Variables

Objective: The main aim of the study was to assess the psychosomatic health status of psychiatric nurses based on sociodemographic variables. Materials and Methods: The research was conducted at the Mazovian Provincial Hospital in Ząbki on a group of 101 individuals working in nursing positions. All participants gave voluntary and free consent to participate in the study. The study obtained approval from the bioethical committee. The health status of the respondents was assessed using a standardized, validated GHQ-28 questionnaire. The level of significance was set at p=0.05. Results: Social dysfunction among participants increased with age and length of employment at the current workplace (p < 0.05). Significantly higher scores (p < 0.05) in this area were observed in individuals in marital relationships and those with higher education. The intensity of anxiety and insomnia was significantly higher (p < 0.05) in individuals in marital relationships, respondents with secondary education, and those with a total work experience exceeding 30 years and over 15 years in the current workplace. The intensity of depressive symptoms was associated with a lack of higher education among respondents. The factor with the greatest impact on somatic symptoms among surveyed nurses (p < 0.05) was age over 50. Conclusions: There is a significant association between the intensity of somatic symptoms, anxiety, insomnia, and functional disorders and the age of participants. There is a significant association between the intensity of anxiety and insomnia symptoms, functional impairments, and the marital status of participants. There is a significant association between the intensity of depressive symptoms, anxiety, insomnia, and social dysfunction and the education level of participants.

Position statement of the Brazilian Palliative Care Academy on withdrawing and withholding life-sustaining interventions in the context of palliative care.

The issue of withrawing and withholding life-sustaining interventions is an important source of controversy among healthcare professionals caring for patients with serious illnesses. Misguided decisions, both in terms of the introduction/maintenance and the withdrawal/withholding of these measures, represent a source of avoidable suffering for patients, their loved ones, and healthcare professionals. This document represents the position statement of the Bioethics Committee of the Brazilian Palliative Care Academy on this issue and establishes seven principles to guide, from a bioethical perspective, the approach to situations related to this topic in the context of palliative care in Brazil. The position statement establishes the equivalence between the withdrawal and withholding of life-sustaining interventions and the inadequacy related to initiating or maintaining such measures in contexts where they are in disagreement with the values and care goals defined together with patients and their families. Additionally, the position statement distinguishes strictly futile treatments from potentially inappropriate treatments and elucidates their critical implications for the appropriateness of the medical decision-making process in this context. Finally, we address the issue of conscientious objection and its limits, determine that the ethical commitment to the relief of suffering should not be influenced by the decision to employ or not employ life-sustaining interventions and warn against the use of language that causes patients/families to believe that only one of the available options related to the use or nonuse of these interventions will enable the relief of suffering.

Clinical manifestation of comorbid endometritis and purulent-necrotic diseases in the claw area of highly productive cows

Recently, due to the intensification of dairy cattle breeding, there has been an increase in the concentration of cattle, while unfavorable conditions are being created for the mother herd, helping to reduce their resistance to various unfavorable factors. Therefore, the study of clinical manifestations in the comorbid course of endometritis with purulentnecrotic diseases in the area of the hooves of highly productive cows, as well as a detailed comparison of the obtained indicators with clinically healthy animals and animals with a separate manifestation of endometritis and orthopedic pathology, in our opinion, is a very relevant area for scientific research. The research was supported by the Russian Science Foundation Grant No. 24-26-00172, https://rscf.ru/project/24-26-00172/. The experiment was approved by the bioethical commission of the Department of Veterinary Medicine of the Russian Biotechnological University, regarding the humane treatment of experimental animals. The research was carried out on the basis of Voskresenskoye JSC, Voskresensky district, Moscow region, with a total population of 1,450 heads of cattle, including 830 cows. The material for the study was cows with endometritis (n=28), animals with orthopedic pathology (n=25) and with a comorbid course of postpartum endometritis and purulent-inflammatory processes in the toes (n=27). Indicators obtained from clinically healthy animals (n=23) were used as control. Using the method of one-way analysis of variance (ANOVA), we established significant changes in the indicators of rumen contractions (F = 12.44; p<0.001), respiratory movements (F = 19.28; p<0.001), pulse (F = 8.21; p<0.001) and body temperature (F = 41.13; p<0.001).

Влияние комбинации пропофол и изофлуран на основные физиологические параметры собак

The drug development process is usually divided into three main stages: development, preclinical evaluation, and clinical trials. The regulatory requirements of international guidelines usually require toxicological and pharmacological studies on at least two types of laboratory animals: rodents and non-rodents. Beagle dogs are often used as model non-rodents to study the efficacy and safety of newly developed drugs and chemicals due to the similarity of their anatomical morphology and physiology to humans. The work is devoted to the study of the effect of a combination of propofol and isoflurane on basic physiological parameters such as: blood pressure, blood oxygen saturation, capnogram, electrocardiogram, heart rate, respiratory rate, body temperature, glucose level. The study was approved by the local Bioethics Commission. 10 males and 10 females of the Beagle breed aged from 1 to 2 years were used. Initially, propofol was administered to all dogs at a dose of 10 mg / kg intravenously, then an endotracheal tube No. 6.0–-6.5 was installed, 4 minutes after the introduction of propofol, isoflurane was supplied with a flow rate of 1 l /min and a concentration of 2 % of the gas mixture. Based on the conducted research, it was found that the combination of propofol and isoflurane has some depressive effects on the cardiovascular and respiratory systems. At the same time, there was no effect on blood glucose levels and blood oxygen saturation. This combination did not cause hypothermia in dogs in the study. The data obtained indicate good tolerability of combined anesthesia, and allow for the widespread use of a combination of propofol and isoflurane in the anesthesiological provision of dogs.

The Influence of Age and Work Experience on Lumbar Spine Pain among the Nursing Staff

Introduction. Currently, back pain syndromes are considered to be widely known problems in the medical, but above all, social and economic aspects. The specific nature of the profession performed by nurses puts them among the people most at risk of spine dysfunction.
 Aim. The aim of this study is to assess the occurrence of pain in the lumbar spine pain among nurses working at the Provincial Specialist Hospital in Włocławek.
 Material and Methods. The research was conducted among 120 nurses working in hospital wards of the Provincial Specialist Hospital in Włocławek. The research used an own survey questionnaire and the Revised Oswestry Low Back Pain Disability Scale (ODI) — the Polish version. Consent to conduct the research was obtained from the Management of the Provincial Specialist Hospital in Włocławek and the Bioethics Committee of the State Academy of Applied Sciences in Włocławek.
 Results. The majority of respondents indicated that they connect back pain with work — 104 people (86.7%) and received the results of slight limitations — 60 people (50.0%). Most respondents indicated that they had experienced pain for 1–5 years — 42 people (35.0%). Respondents aged up to 45 years indicated that they had been experiencing pain for 1–5 years — 15 people (48.4%). In the group with 30–40 years of experience, the most respondents indicated that they had more than 10 years of experience — 19 people (34.5%). In the group with 30–40 years of experience, the majority indicated that often several times a month — 21 people (38.2%). The highest degree of disability was recorded at the age of 56–62, serious disruptions — 8 people (33.3%), and at the age of 51–55, serious disruptions — 6 people (14.03%).
 Conclusions. The work performed affects the occurrence of pain in the lumbar spine. Age groups up to 45 years and 46–50 years have been experiencing pain for 5–10 years. Pain is most often experienced by respondents with 30–40 years of work experience. The vast majority of respondents experience slight limitations. The highest rate of disability is experienced by nurses aged 51–55. (JNNN 2023;12(4):164–169)

Лайм-кардит у підлітка (клінічний випадок)

In recent years, the number of registered cases of Lyme carditis has been increasing. Purpose - to increase the vigilance of clinicians in various fields of medicine regarding Lyme carditis and awareness of its clinical manifestations on the example of the following clinical case. An empirical, descriptive study of a clinical case of Lyme pericarditis in a child from an endemic area was conducted. The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the bioethical commission of the hospital. Patient consent was obtained. An analysis of the literature data of PubMed, Medscape, СDC was also carried out. Clinical case. The paper describes a clinical case of a teenager with manifestations of pericarditis as a complication of Lyme infection with manifestations of untreated erythema migrans several months after a tick bite. The appointment of non-steroidal anti-inflammatory drugs did not bring relief. Conclusions. Alertness to Lyme carditis is important in the diagnosis of infectious nosologies. Lyme carditis should be considered in the differential diagnosis in patients with signs of myocardial ischemia in children with bradycardia living in endemic areas. For differential diagnosis, a two-step serological blood test is required, especially the use of screening tests for antibodies to Borrelia by ELISA with further confirmation by Western blot analysis. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Вариабельность биохимических показателей крови и установление референтных интервалов в доклинических исследованиях. Сообщение 11: собаки

Dogs are a common in vivo test system in preclinical studies due to the relatively large body size sufficient for surgical manipulations, as well as the pathophysiology of various diseases similar to humans. A separate point of application of the animal species in question in preclinical studies is the study and therapy of oncological diseases. The aim of the work was to create its own database of reference intervals of biochemical blood parameters of Beagle dogs. These norms are necessary in preclinical studies when asses­sing the state of animal health, monitoring the formed pathological model, as well as checking the safety of the studied drugs. Biological samples used for the formation of reference intervals were obtained from intact animals in research and manufacturing company “Home оf Pharmacy”. All manipulations and experiments carried out were approved by the bioethical commission. The study included 56 males and 48 females. The age of the animals corresponded to the range of 10–18 months, the body weight of females was 7–11 kg, and males 8–14 kg. In order to implement a uniform approach when creating reference intervals, all manipulations were carried out under the same conditions. For the study, blood was used, which was taken from the lateral subcutaneous vein of the leg of the studied animals on an empty stomach, without sedation and anesthesia. The following parameters were recorded in the blood serum of animals: creatinine, urea, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, cholesterol, triglycerides, total protein, albumin, glucose, creatine kinase, lactate dehydrogenase and total bilirubin, the albumin-globulin coefficient was calculated. Statistical outliers were estimated using the Tukey method, the type of distribution was determined using the Shapiro—Wilk criterion, paired comparisons between animals of different sexes were carried out using the Mann—Whitney U-test and the Student t-test. The obtained ranges of values of males and females correlated with each other for all the considered indicators, no statistical difference was revealed. When comparing the obtained intervals with the reference ranges of dogs from other literature sources, it was shown that, in general, the ranges of the considered indicators are similar, but there are also differences that can be explained by a wide list of factors. These include the image of keeping animals, as well as the preanalytical and analytical stages of the study. A comparative analysis of the interindividual variability of the biochemical parameters of the blood of dogs and humans showed the presence of some species differences that need to be taken into account in experimental activities.

The content of matrix metalloproteinase-1, -9 and tissue inhibitor of matrix metalloproteinase-1 in patients with bronchial asthma and obesity

Airway remodeling is a significant factor in the progression of respiratory failure in bronchial asthma (BA). Obesity can contribute to inflammation, and consequently – airway remodeling, by increased production of matrix proteinase (MMP). However, the mechanisms of remodeling in different phenotypes of BA, especially in comorbid patients, remain poorly understood. The aim of the research was to examine the levels of remodeling markers MMP-1, MMP-9 and tissue inhibitor of matrix proteinases (TIMP-1) in obese asthmatic patients, taking into account their age at the onset of BA, the severity of symptoms and the level of control. Material and methods. 195 patients with BA associated with obesity were examined. The control group consisted of 95 practically healthy people. Patients were divided into two groups: Group I included 100 patients with early onset, and Group II included 95 patients with late onset of BA. The study was approved by the Bioethics Commission of the Medical Institute of Sumy State University. Statistical analysis of the obtained results was carried out using the SPSS-17 program. Results. The content of MMP-1, -9 and TIMP-1 was higher in patients with early (129.40 ± 7.86; 177.30 ± 9.19; 142.40 ± 12.22 ng/ml, respectively) and late (196.60 ± 9.62; 289.80 ± 16.23; 187.50 ± 11.34 ng/ml, respectively) BA with obesity compared to practically healthy individuals (р < 0.005). Patients with late-onset BA associated with obesity likely had higher indicators than those with early BA. In patients with early BA, the levels of MMP-1, -9, and TIMP-1 were not significantly different depending on the severity of the disease (р > 0.05). However, in patients with severe late BA, the levels of these markers were higher compared to those with mild BA (р < 0.05). Levels of MMP-1 and MMP-9 in patients with early-onset and late-onset BA with obesity were higher in the absence of disease control compared to those in complete and partial control, but in late-onset exceeded those in early-onset. Conclusions. Considering the obtained results, it can be assumed that the level of MMP-1, MMP-9 and TIMP-1 in obese patients with BA can serve as biomarkers of airway remodeling, namely, the severity and the level of BA control.