Pomeranian Medical University Research Articles

Assessment of Biochemical Parameters in 8- and 9-Year-Old Children with Excessive Body Weight Participating in a Year-Long Intervention Program.

Childhood obesity represents a significant challenge both clinically and socio-economically. This study aimed to assess specific biochemical parameters, particularly glucose, insulin and lipid profile, before and after a year-long intervention program in 8- and 9-year-old children with excessive body weight living in Szczecin, Poland from 2016 to 2018. The research comprised two phases: screening in elementary schools and intervention in the outpatient clinic of the clinical Pomeranian Medical University hospital. Out of 11,494 8- to 9-year-olds in Szczecin, 42.54% (4890) participated in the screening. In the intervention phase, 515 children were examined. Anthropometric measurements were recorded at each visit, and blood samples were collected during the first and fourth visits. In the statistical analysis, the Kolmogorov-Smirnov, t-Student and ANOVA tests were employed (with statistical significance when p ≤ 0.05). Results highlighted a significant proportion of children exhibiting disruptions in carbohydrate and lipid metabolism. A total of 8.6% of participants had elevated total cholesterol, 9.7% had reduced HDL, 13.4% had elevated LDL, and 21.2% had elevated triglycerides. Initially, abnormal fasting glucose was detected in 4.7% of children, and elevated insulin levels in 3.1%. Metabolic disorders persisted post-intervention despite BMI improvement. The results emphasize the necessity for prolonged programs with frequent follow-ups targeting weight normalization in children.

Molecular Diagnosis of COVID-19 Sudden and Unexplained Deaths: The Insidious Face of the Pandemic.

The COVID-19 epidemic has led to a significant increase in the number of deaths. This has resulted in forensic autopsies focusing on additional diagnostic possibilities. The following article is a summary of 23 autopsies of sudden and unexplained deaths. Particularly noteworthy are the described cases of children whose deaths were originally classified as SIDS (sudden infant death syndrome). All tests were performed at the Department of Forensic Medicine and Forensic Genetics, Pomeranian Medical University in Szczecin. Autopsy analyses were extended to include diagnostics of the SARS-CoV-2 virus using molecular methods and a detailed histopathological analysis of lung tissue. The material for molecular tests consisted of a nasopharyngeal swab taken postmortem and a lung tissue homogenate. In both cases, the RT-PCR method with CT cut-off point analysis was used for diagnosis. In all analyzed cases, the lungs showed massive congestion and increased fragility and cohesion. The tested material showed the presence of the SARS-CoV-2 virus, which indicated various stages of infection. It was observed that the higher the virus expression in the lungs, the lower or undetectable it was in the nasopharyngeal swab. This may explain false negative results during life in swabs. An interesting finding is that child deaths classified as SIDS also showed the presence of the virus. This may constitute a new direction of research.

Exploring factors influencing depression among Polish nurses during the COVID-19 pandemic.

The COVID-19 pandemic has been recognized as an international public health emergency. The aim of our study was to identify contributors to nurses' depression. This survey-based study was conducted in the Pomeranian Medical University Hospital no. 1 in Szczecin and involved 207 nurses. The following standardized research instruments were applied: the World Assumptions Scale, the Athens Insomnia Scale, the Impact of Event Scale - Revised, the Patient Health Questionnaire-9, the Generalized Anxiety Disorder, the Perceived Stress Scale, and a questionnaire of our own authorship. The study showed that 72.95% of the subjects experienced severe stress, and 40.58% suffered from insomnia. In addition, 65.7% of the respondents had anxiety symptoms of varying degrees of severity, and 62.8% had depressive symptoms of mild to severe severity. The mean score on the IES-R scale, reflecting a psychological impact of the COVID-19 pandemic, was 34.25. The COVID-19 pandemic affected the psychological health of medical staff, particularly through increased stress and anxiety symptoms. Anxiety levels and insomnia significantly affect the prevalence of depression among nurses. The COVID-19 pandemic has been recognized as an international public health emergency. The COVID-19 pandemic affected the psychological health of medical staff, particularly through increased stress and anxiety symptoms. It is important to conduct further research after the COVID-19 pandemic has ended.

Preoperative Oral Carbohydrate (CHO) Supplementation Is Beneficial for Clinical and Biochemical Outcomes in Patients Undergoing Elective Cesarean Delivery under Spinal Anaesthesia-A Randomized Controlled Trial.

Preoperative fasting and surgery cause metabolic stress, insulin resistance with ketosis, and postoperative nausea and vomiting (PONV). Oral carbohydrate loading strategy (CHO) improves outcomes in labor and general surgery. We aimed to compare the effectiveness of CHO with standard fasting in patients undergoing elective cesarean delivery (CD) under spinal anesthesia. A single-center, parallel, prospective randomized controlled trial (RCT) was conducted in a tertiary university obstetrics department at Pomeranian Medical University in Szczecin, Poland. Patients were randomly assigned (1:1 ratio) to the CHO group (oral carbohydrate 2 h before elective CD, n = 75) or the SF group (control-standard fasting, n = 73). The main outcome measures were incidence and severity of PONV at 6 and 24 h after CD, time to the first peristalsis, time to first bowel movement, and biochemical parameters indicating ketosis in mothers and their children. A total of 148 adult females with singleton pregnancies undergoing elective CD under spinal anesthesia (ASA I and II) were included in the final analysis. At 24 h after CD, 8.0% from the CHO group vs. 20.55% reported three or more episodes of vomiting or dry retching as compared to patients in the SF group (p = 0.041). Preoperative CHO supplementation decreased preoperative feelings of hunger (p < 0.001) and thirst (p < 0.001). Laboratory results in the CHO group showed higher plasma pH (p = 0.001) and glucose (p < 0.001), lower F2-isoprostane in plasma (p = 0.049) and urine (p = 0.018), lower urine F2-isoprostane/creatinine ratio (p = 0.045) than in the SF group. HOMA-IR (p < 0.001) and lactate (p < 0.001) were higher in the CHO group than in the control group. There was no significant difference in the incidence or severity of early PONV at 6 h. The incidence of vomiting or dry retching at 24 h after cesarean delivery was lower in the CHO group as compared to standard starvation, but the combined results of PONV frequency and severity on the Wengritzky scale did not differ between the two study groups. Preoperative CHO supplementation decreased preoperative feelings of hunger and thirst, enhancing the comfort of pregnant women. ClinicalTrials.gov identifier: NCT04069806.

The Rate of Postoperative Mortality and Renal and Respiratory Complications are Increased in Patients with Extreme Obesity Undergoing Cardiac Surgery - A Retrospective Observational Cohort Study of 8848 Patients.

The importance of obesity as a potential risk factor in open heart surgery is well known. The epidemic of extreme obesity is an increasing public health concern and raises alerts regarding postoperative complications and mortality in patients undergoing cardiac surgery. The study aimed to analyze the impact of extreme obesity (BMI≥40) on the frequency of postoperative complications, as well as early and delayed mortality compared to patients with a lower body mass. This retrospective observational cohort study involved patients, over the age of 18, undergoing cardiac surgery with cardiopulmonary bypass at the Cardiac Surgery Department of the Pomeranian Medical University in Szczecin, Poland between January 1st, 2010 and December 31st, 2018. The patients included in the study were allocated into two subgroups depending on the BMI index (Group I BMI≥40 vs Group II BMI<40). A total of 8848 adult patients of both genders were included. Baseline characteristics for Group I and Group II were mean age 64.07±7.76 vs 65.10±9.68 years (p=0.123), mean BMI 42.13±2.44 vs 28.55±4.23 (p<0.001), with more females in Group I (58.04% vs 29.06%) and more males in Group II (70.94% vs 29.06%), p<0.001. The predicted perioperative risk using the EuroScore Logistics scale was higher in a group with BMI≥40 (p<0.001). Regression analysis with adjustment for confounding factors showed a statistically significant relationship between BMI≥40 and postoperative respiratory failure (OR=1.760, p=0.043), acute kidney injury AKIN2 (OR=2.082, p=0.044) and AKIN3 (OR=2.743, p=0.039). 30-day mortality in the univariate analysis showed a statistically significant relationship, however, after modifying the results with interfering factors, no statistical significance was obtained. The risk of postoperative acute respiratory failure and acute renal injury was increased in patients with BMI≥40. The probability of 30-day survival of patients after cardiac surgery was much lower in people with extreme obesity, although it was related to the dominant comorbidities. The 10-year survival was comparable in both groups.

Candida Species in Children Undergoing Orthodontic Treatment with Removable Appliances: A Pilot Study

The purpose of this study was to analyze the effect of orthodontic treatment with removable appliances on the growth of Candida spp. in children undergoing orthodontic treatment. The study included 60 patients of equal numbers as to gender from the orthodontics department of the Pomeranian Medical University in Szczecin, Poland. All patients were aged 6-12 years and were qualified for orthodontic treatment with removable appliances. The following examinations were performed on the day of treatment initiation (T1) and 6 months after the start of treatment (T2); a collection of oral swabs for culture on Sabouraud's medium and the identification of fungal colonies using the VITEK®2 YST. At T1, 42 (70%) subjects, were free of Candida, while after 6 months of treatment, the number decreased to 25 (41.67%). Two types of fungi, C. albicans and C. parapsilosis, predominated in the test performed at T1. The study at T2 showed that C. albicans most frequently colonized the oral cavity in 23 children (38.33%). Three new strains C. dubliniensis, C. kefyr, and C. krusei were identified at T2. Statistical analysis showed a significant correlation between the culture results and the age of the patient at T2. Patients older than 9 years had significantly more positive tests. Orthodontic treatment with removable appliances contributes to increased oral colonization by Candida spp.

Assessment of the Impact of Pentafecta Parameters Affecting the Quality of Life of Patients Undergoing Laparoscopic Radical Prostatectomy.

Prostate cancer is being detected in increasingly younger men. These patients expect to preserve their current quality of life and quickly recover after treatment. Medical technology and surgical techniques are advancing along with the growing expectations of patients. In addition, the universal method of assessing the quality of outcomes after operations is constantly being researched. As of today, biochemical remission alone, after radical prostatectomy, is insufficient for the patient. Therefore, multi-parametric evaluation methods are being developed, such as trifecta, which assesses biochemical remission, continence, and erectile function. The improvement over the trifecta is the pentafecta, which additionally evaluates postoperative complications and infiltration of surgical margins. Our study was conducted within a group of patients who were surgically treated for prostate cancer in 2017 at the Clinic of Urology and Urological Oncology of the Pomeranian Medical University. We recruited 237 men for the study. From that group, 131 men met the criteria to be included in the analysis. Maintaining continence (87.78%) is the easiest pentafecta parameter to obtain and will have the greatest impact on quality of life in the future. Maintaining biochemical remission (82.44%) is the second most important aspect for the patient. Retaining erectile function is the most difficult pentafecta parameter to obtain (29.01%) while having little impact on the quality of life. Negative surgical margins (66.41%) showed a negligible impact on the quality of life. The occurrence of complications (32.07%) has a negative impact on the quality of life of patients, but only during the treatment of complications.

Treacher Collins syndrome – a case report

Abstract Objectives Treacher Collins syndrome (TCS), also known as mandibulofacial dysostosis and Franceschetti-Zwahlen- Klein syndrome, is an autosomal dominant disorder of soft tissue and the craniofacial bones. In most cases, TCS is the result of a mutation in the TCOF1 gene. The incidence is estimated to be between 1/10,000 and 1/50,000 live births. Our purpose was to describe a case report of patient with TCS born in the Department of Neonatology at the Pomeranian Medical University in Szczecin (Poland) and his family with short review of literature. Case presentation Clinical abnormalities which were found after birth mainly affect the head – hypoplasia of the cheek bones and the zygomatic bones, micrognation, deformed auricles with undeveloped external auditory canals, retrognathia of the mandible, cleft hard and soft palate and narrow palpebral fissure. Conclusions The treatment of children with TCS is long-term. Patients require a series of reconstructive and plastic surgical procedures. Our patient presented the complete form of TCS. There are multiple surgeries awaiting him, which, eventually, will improve his quality of life.

Immune restoration affects 10-year survival in people living with HIV/AIDS.

In recent years, a reduction in the life expectancy gap between people living with HIV (PLWH) and the general population has been observed, irrespective of CD4 lymphocyte count, due to widespread access to antiretroviral treatment. The increase in the life expectancy of PLWH has increased awareness of both the ageing process and gender discrepancies in immune restoration and survival. Longitudinal data were collected for 2240 patients followed up at the Hospital for Infectious Diseases in Warsaw, Poland (n=1482), and the Department of Acquired Immunodeficiency, Pomeranian Medical University, Szczecin, Poland (n=758). Immune restoration was measured from the time of starting combination antiretroviral therapy until achieving 500 CD4 lymphocytes/μL, 800 CD4 lymphocytes/μL, and CD4/CD8 lymphocyte ratios of > 0.8 and > 1.0. Full recovery was achieved when the patient was restored to both 800 CD4 lymphocytes/μL and a CD4/CD8 lymphocyte ratio > 1.0. For all endpoints, immune restoration had a protective effect by reducing mortality. Patients who achieved immune restoration had a greater chance of reduced mortality than those who did not achieve immune restoration: for CD4 count > 500 cells/μL, HR=5.4 (interquartile range: 3.09-9.41), p < 0.001; for CD4 > 800 cells/μL, HR=5.37 (2.52-11.43), p < 0.001; for CD4/CD8 ratio > 0.8, HR=3.16 (1.81-5.51), p < 0.001; for CD4/CD8 ratio > 1.0, HR=2.67 (1.49-5.24), p=0.001, and for full immune recovery, HR=3.62 (1.63-8.04), p=0.002. Immune restoration remains a powerful factor in improving the survival of PLWH, regardless of the speed of recovery.

Fluoride varnish, ozone and octenidine reduce the incidence of white spot lesions and caries during orthodontic treatment: randomized controlled trial

This randomized, parallel, controlled trial assessed the effect of fluoride varnish, ozone and octenidine on white spot lesions (WSLs) and caries during orthodontic treatment. Patients were enrolled between 1st September 2017 and 31st August 2020 at initiation of orthodontic treatment in Department of Interdisciplinary Dentistry Pomeranian Medical University in Szczecin, Poland. All participants were randomly assigned to four study and one control groups using number random generator. However, investigators were not blinded due to the nature of the study. Groups I, II, III, IV had professional cleaning and varnishing (5% NaF) every 4 weeks. Groups II and IV had in-office ozone therapy before varnishing, groups III and IV received domestic octenidine mouthrinse. Group K had no professional hygienic or prophylactic procedures. WSLs were assessed at T0 and then every 4 weeks (T1–T4) and caries—at T0 and T4. The specific objective was to assess the influence of fluoride varnish, ozone and octenidine on the incidence of white spot lesions and caries during orthodontic treatment. The primary outcome of this report was the highest number of WSLs in group K and the lowest percentage of patients with WSLs in group IV. Each group comprised 30 randomized participants; they were all analyzed. No WSLs were found at T0, but they were stated in all groups at T4. The numbers of patients with WSLs significantly increased between T0-T4 in groups I and K. Group IV had the lowest percentage of patients with WSLs in T1-T4. WSLs in group IV were found no earlier than at T2. Group K had the highest percentage of WSLs at T4: 26%. At T0 all the groups had DMFs above 0 with a significant increase at T4. No side effects of the introduced prophylaxis were observed in any group. Caries is an important problem of fixed orthodontic treatment. Even an extremely intensive prophylaxis could not completely prevent WSLs and caries. Simultaneous application of fluoride varnish, ozone gas exposure and octenidine appears to have a beneficial effect in limiting the development of WSLs.Trial registration: NCT04992481.

Effects of a 980 nm Diode Laser as an Adjunct to Nonsurgical Periodontal Therapy on Periodontal Status and Inflammatory Markers in Patients After Myocardial Infarction: A Randomized Controlled Trial.

Objective: The aim of this study was to evaluate the efficacy of diode laser (DL) therapy as an adjunct to nonsurgical periodontal therapy in the treatment of periodontitis in patients after myocardial infarction (MI). Methods: After given permission by Ethics Commission of the Pomeranian Medical University (KB-0012/06/12), 36 patients <65 years of age (mean: 56.3 ± 7.9) with periodontitis, 6 weeks to 6 months after MI were enrolled for the study. The control group (n = 18) received nonsurgical periodontal therapy, whereas the test group (n = 18) received nonsurgical periodontal therapy followed by laser therapy of the periodontal pockets with 980 nm DL, 1 W, continuous wave mode, and 20 sec per tooth side. Procedures were repeated twice at 5-7 day intervals. Clinical periodontal parameters and inflammatory markers in gingival crevicular fluid (GCF) [elastase, aspartate transaminase (AST), alanine transaminase (ALT) and interleukin (IL)-6, proteins], bloodstream [fibrinogen, high-sensitivity CRP (hs-CRP), IL-6, AST and ALT], and lipid fractions (triglycerides, high-density lipoprotein, low-density lipoprotein, and total cholesterol) were measured before treatment, 2 weeks, and 3 months after treatment. Results: The difference between groups in the reduction of periodontal pocket depth (PPD) in pockets ≥7 mm was found to be significant in the test group (p < 0.05). There was also a statistically significant reduction in the volume of GCF and hs-CRP concentration in blood 2 weeks after the completion of treatment in the test group (p < 0.05). Conclusions: Within the limits of this study, it can be concluded that in the nonsurgical treatment of periodontitis with patients after MI, the additional use of DL enables greater reduction of PPD in pockets ≥7 mm. In addition, a faster reduction of GCF volume and hs-CRP was noted in the laser group.

Protozoan Intestinal Parasitic Infection in Patients with Hematological Malignancies.

The aim of this study was to evaluate the frequency of gastrointestinal protozoan infection in patients with hematological malignancies (HMs) undergoing intensive hemato-oncological treatment and to determine the influence of certain biological factors on the incidence of intestinal parasite infection. Stool samples were collected from hematological malignancy patients (n = 50) hospitalized at the Department of Hematology and Transplantology of the Pomeranian Medical University in Szczecin. The control group consisted of 50 healthy participants. We used a direct smear examination and a commercial immunoenzymatic test. Intestinal protozoans were detected in 16% of patients with hematological malignancies and in 6% of individuals in the control group. In stool samples from patients with HM, cysts of Giardia intestinalis (2%), oocysts of Cryptosporidium spp. (10%), vacuolar forms of potentially pathogenic Blastocystis spp. (2%), and cysts of nonpathogenic Entamoeba coli (2%) were found. Cryptosporidium spp. and Giardia intestinalis coproantigens were detected in 5 (10%) and 1 (2%) patients with HM, respectively. In three participants from the control group, vacuolar forms of Blastocystis spp. were found. In the patients with HM, a significantly higher prevalence of intestinal parasite infection was found in individuals working in the garden without protective gloves and those in contact with animals. In patients with hematological malignancies, intestinal parasites should be excluded, even during intensive chemotherapy treatment.

Self-efficacy and fatigue perceived by nursing students in Poland, Spain and Slovakia during the COVID-19 pandemic.

The two-year long epidemic situation around the world has resulted in an increasing number of people experiencing "pandemic fatigue". The aim of this study was to examine the correlation between a sense of self-efficacy and fatigue experienced in everyday life by nursing students in Poland, Spain and Slovakia during the COVID-19 pandemic. The study was conducted by the diagnostic survey method on a group of 756 nursing students of the first-cycle degree program, from 20 March to 15 May 2021, in the University of Warmia and Mazury in Olsztyn, Pomeranian Medical University in Szczecin (Poland), as well as in Murcia University (Spain) and in the Catholic University in Ružomberok (Slovakia). The sense of self-efficacy was significantly lower among the students in Poland than in those in Spain (p < 0.0001) and in Slovakia (p < 0.0001). Students in Slovakia showed symptoms of general, physical, cognitive and psychosocial fatigue much less frequently than those in Poland (p < 0.001) and Spain (p < 0.001). Especially students in Spain acutely felt physical health issues as a result of COVID-19 pandemic-imposed restrictions. A high level of a generalized sense of self-efficacy among the nursing students participating in the study was identified. However, it was significantly differentiated with respect to the country of residence. The fatigue severity experienced by the students during the COVID-19 pandemic was determined by a sense of self-efficacy.

Rapid Access in Donation After Circulatory Death (DCD): The Single-Center Experience With a Classic Pathway in Uncontrolled DCD Algorithm

In Poland, 95% of organs for transplantation come from donation after brain death (DBD). In 2010, Poland officially joined the European countries in which donation after circulatory death is accepted by law. Currently, the Pomeranian Medical University Transplant Center is the only active location for uncontrolled donation after circulatory death (uDCD) in Poland. To estimate the results of uDCD kidney transplantation with a classical approach to organ recovery, we analyzed data from an early phase of uDCD program. Prospective observation of uDCD kidney allografts (group 1; n=8) compared with DBD kidney allografts (group 2; n=30). The organ recovery protocol was set up on rapid abdominal access without regional perfusion before procurement. The organs recovered from uDCD during a 24-month period increased the volume of kidneys transplanted at the center by 9.2%. Delayed graft function was diagnosed in 100% vs 46% of allografts (P=.03), respectively. Nevertheless, early posttransplant follow-up did not reveal any graft loss or recipient death cases in the DCD group. After 12 months of follow-up, the mean glomerular filtration rate was 44.5 vs 57.9 mL/min (P < .02), respectively. Crucial factors for acceptable results of uDCD are strict pretransplant assessment of recovered organs and efficient coordination of the transplant team. Conservative recovery protocol in uDCD under strict prerequisites is feasible to consider in the organ procurement pathway. Preliminary results provide space for an increase in the organ donor pool.

Cause-Effect Relationships between Painful TMD and Postural and Functional Changes in the Musculoskeletal System: A Preliminary Report.

Introduction Temporomandibular disease (TMD) is a general term including a group of conditions that cause pain and dysfunction in the masticatory muscles, the temporomandibular joint (TMJ), and their related structures. The painful forms of these dysfunctions have become an increasing phenomenon among dental patients. A number of scientific publications indicated the relationship between the presence of postural dysfunctions and functional disorders of the masticatory system in humans. Nevertheless, dental procedures still very rarely include comprehensive diagnostics and procedures aimed at the normalization of the locomotor system related to TMD. Scientific literature usually refers to and describes the coexistence of postural disorders in patients with TMD in the context of anatomical connections, the so-called biokinematic chains, indicating specific types of postures that correlate with different positions of the mandible and/or teeth. Objective The aim of the study was to investigate the effect of painless positioning of the mandibular head in the articular fossa on postural and functional changes in the musculoskeletal system. Materials and Methods The study was conducted on a group of 30 randomly selected patients who reported to the Department of Propaedeutic, Physical Diagnostics and Dental Physiotherapy of the Pomeranian Medical University in Szczecin (Poland). Before the examination, the dentists and the physiotherapist were calibrated by an examiner who had previously been calibrated and had three years of experience in the management of patients with TMD. Training of the appropriate palpation strength was performed, and then the results were discussed. In the study group, painful disorders in the temporomandibular joint with an abnormal position of the mandibular head in the articular fossa and individual posture defects were found. The patients complained of pain in the area of the TMJ, episodes of locked joints, and difficulty biting. None of them was treated for these disorders, previously rehabilitated or participated in any body posture examination. The patients were examined by an interdisciplinary team who also performed a preliminary test. The inclusion criterion for the study group was the presence of TMD symptoms in the past. Myofascial pain was diagnosed on the basis of diagnostic criteria for temporomandibular disorders (RDC/TMD Ia and Ib). On the other hand, the displacement of the articular disc was diagnosed on the basis of the diagnostic criteria of temporomandibular disorders (RDC/TMD IIa)—displacement of the articular disc without reduction. At the same time, the body posture was assessed by inspection and using computer techniques while standing and during motion. The examinations were repeated after positioning the mandibular heads in the articular fossa and stabilizing the condylar process using a temporary silicone occlusal splint. Since there is no DC/TMD protocol in Polish to date, RDC/TMD was used in the study. Results Initial pilot studies and the authors' observations indicated that the positioning of the mandibular heads in the articular pits and stabilization of the condylar process by providing the oral cavity with a temporary, silicone occlusive splint significantly influenced the posture of the examined patients, both while standing and during locomotion. This correlation also applies to the corrective effect on the foot architecture during standing and patient gait. Conclusions Diagnostic and therapeutic management in the course of TMD should be holistic. Nevertheless, the observed changes are often varied and largely dependent on individual posture defects, which is an important postulate for further research on a larger study group.

Assessment of Psychosocial Functioning of Polish Nurses during COVID-19 Pandemic.

(1) The COVID-19 pandemic has significantly affected the psychological well-being of people around the world. The aim of this study was to assess the levels of psychological distress of nurses (anxiety, depression, stress, insomnia) in relation to sociodemographic variables and psychosocial variables: self-assessment of health, quarantine, psychological support, presence of chronic diseases and the Impact of Events Scale (IES-R). (2) A total of 207 nurses working with COVID-19 patients at the Independent Public Clinical Hospital No. 1 of the Pomeranian Medical University in Szczecin participated in the study. The study was conducted with the diagnostic survey method, using the Athens Insomnia Scale, the Generalized Anxiety Disorder questionnaire, the Impact of Event Scale—Revised, the Patient Health Questionnaire-9, The Perceived Stress Scale and a questionnaire of our authorship. (3) Among the respondents, 40.58% suffered sleep disturbance, 36.71% had mild anxiety, 71.95% had high stress according to the PSS-10 and 31.88% had depression according to the PHQ-9. The study observed that the chances of insomnia decreased with the age of the respondents. Moreover, the form of employment of nurses significantly affected the levels of depression, anxiety and stress. (4) Education, gender and age were variables that significantly affected the severity of anxiety, depression and insomnia in the surveyed nurses working with patients with COVID-19.

Reaching out to the World: Pomeranian Medical University′s Connections to International Networks of Knowledge Production and Circulation, 1956–1968

This study explores the effects the political “Thaw” of 1956 had on the ability of the Pomeranian Medical University of Szczecin, Poland (PUM) to join and contribute to the international production and circula- tion of medical knowledge in the years 1956–1968. It gives an overview of the challenges PUM had to face in its relationships with the state apparatus that controlled access to foreign networks. It also discusses the cases of three PUM professors, namely: Bolesław Górnicki (1908–1998; head of Paediatrics), Witold Starkiewicz (1906–1978; head of Ophthalmology), and Kazimierz Stojałowski (1903–1995; head of Pathological Anatomy). For the first of them, Szczecin was a nine-year episode in a prosperous academic career closely tied with Warsaw; the latter two were among PUM’s founding staff and stayed in Szczecin till retirement. The study reveals how personality, political and confessional worldview, strength of personal attachment to PUM, and diplomatic skills exhibited by each of the three professors influenced the range, the quality, and the durability of connections they established between PUM and the world.

Clinical parameters, selected HLA and chemokine gene variants associated with late presentation into care of people living with HIV/AIDS.

Late presentation into care remains a significant problem in the diagnosis of HIV infection, and may negatively impact the Joint United Nations Program HIV/AIDS elimination targets. Host genetics affects the tempo of HIV disease progression and therefore may influence clinical status at care entry. Longitudinal data were collected for 863 Caucasian patients followed up at Pomeranian Medical University, Szczecin, Poland. Single nucleotide polymorphisms in CCR2 (rs1799864), CX3CR1 (rs3732378), HLAC-35 (rs9264942), CCR5 promoter (rs1799988) as well as 32 base pair CCR5 mutation and HLA-B*5701 genotypes were correlated with the clinical and immunologic patient status at care entry. Late presentation was defined as baseline CD4 lymphocyte count <350 cells/μL or history of AIDS-defining illness, while advanced HIV disease as baseline CD4 lymphocyte count <200 cells/μL or AIDS. Of the analyzed gene variants, the CCR2 (rs1799864) GG genotype was more frequent among patients presenting for care with a CD4 lymphocyte count <200/μL (82.6% for GG homozygotes vs. 74.5% for allele A carriers, p=0.01). The presence of the heterozygous wt/Δ32 genotype at the CCR5 gene was associated with a higher frequency of asymptomatic infection (18.9% for wt/Δ32 heterozygotes vs. 12% for wt/wt homozygotes, p=0.03). As expected, this association was also observed among late presenters compared to patients presenting for care earlier (13.7% vs. 19,7%, respectively, p=0.04). Finally, HLA-B*5701 was less common among late presenters (5%) compared to patients who entered care early (9.6%, p=0.01) or patients with advanced HIV disease (8.9% vs. 5.2%, p=0.02). Late presentation was associated with the GG homozygous genotype at the CCR2 rs1799864 SNP, while both the HLA-B*5701 variant and the CCR5 wt/Δ32 were associated with more favorable clinical profile at care entry.

1,000-m Rowing Ergometer Time Trial Performance in Female and Male Collegiate Rowers

Introduction. The purpose of this study was to evaluate the time of covering a distance of 1000 m on a rowing ergometer by competitors of the Academic Sports Association of the Pomeranian Medical University and to relate the achieved results to the best results from the Polish Rowing Ergometer Academic Championships. Methods. 28 rowers were tested in the 1000 m "maximum" test (1000TM/t). In addition, correlations were sought between the time and power values obtained in the 1000 TM/t with the values of selected anthropometric indices (height and weight, body mass index BMI), hand grip strength, heart rate and body composition components (free fat mass FFM, skeletal muscle mass SMM). Results. The significant correlation between the time and power output in 1000TM/t and values of FFM, SMM, handgrip strength test as well as resting HR have been observed. Conclusion. The results obtained at 1000TM/t can be considered promising for the further training stage due to the fact that the study was conducted on a rowing ergometer under training conditions prior to a special training mesocycle shaping strength and speed, while the athletes competing at the event to which our results were related were in peak competitive performance.

Smoking as a factor influencing the rehabilitation process after cardiac surgery

Introduction: Comprehensive cardiac rehabilitation is a standard therapeutic procedure in patients after cardiac surgery. Its course depends on many factors. One of them is smoking. Exposure of the body to tobacco compounds reduces the supply of oxygen to the organs, which in turn has a damaging effect on the heart tissue.Objective: The aim of this study is to determine the effect of smoking on the effectiveness of rehabilitation in patients after cardiac surgery.Materials and methods: The research was carried out at the Department of Cardiac Surgery, SPSK 2, Pomeranian Medical University in Szczecin. The research was conducted among 35 patients, divided into 3 groups. The first group of 9 people (26%) were non-smokers. The second group was assigned to 11 people (31%) who were heavy smokers. The third group consisted of 15 people (43%) who had been addicted to cigarettes in the past. The research tool used in the study was the 6-minute walk test.Results: Non-smokers achieved a greater improvement in the 6-minute test score compared to the group of smokers and ex-smokers, whose mean score was lower by 39.17 m (± 100.80) and 85.74 m (± 80.56), respectively.Conclusion: Smoking may have an impact on the exercise capacity and exercise tolerance in patients after cardiac surgery.