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Sercowo-naczyniowe działania niepożądane leków przeciwpsychotycznych – przegląd literatury
Get PDFIntroduction: Antipsychotic medication, frequently prescribed for managing psychosis, significantly enhance the quality of life for psychiatric patients. Nonetheless, they also harbor the risk of triggering cardiovascular side effects, which can range in severity and may pose challenges for patients, potentially disrupting their therapy. This study aims to elucidate these adverse effects, their potential etiology, and their prevalence.
Material and methods: A review of available literature was performed by searching PubMed and Google Scholar, using the following keywords: antipsychotic drugs, adverse effects, cardiotoxicity, arrhythmia for original papers, review papers and meta-analyses published from 1992 to 2024.
Discussion: It has been well-known for a long time that antipsychotic medication carries a lot of possible adverse effects. The cardiovascular adverse effects associated with antipsychotic medication encompass orthostatic hypotension, prolongation of the QT interval, atrial fibrillation, alterations in heart rate and cardiotoxicity, which may include myocarditis and cardiomyopathy. Fortunately, the occurrence of the most severe complications stemming from these effects is relatively uncommon. While the adverse effects of first and second-generation antipsychotics are extensively documented, further research is warranted to investigate the potential side effects of third-generation antipsychotic drugs.
Conclusions: Cardiovascular adverse effects associated with antipsychotics can pose significant challenges and may even be life-threatening for patients. However, awareness of these effects should not discourage clinicians from prescribing them. Instead, it should motivate them to deepen their understanding and expertise. It would definitely lead to the improvement of patient care and treatment outcomes.Wstęp: Leki przeciwpsychotyczne, używane głównie w leczeniu schizofrenii, znacznie poprawiają jakość życia pacjentów psychiatrycznych. Niemniej jednak, pacjenci ci są zagrożeni sercowo-naczyniowymi działaniami niepożądanymi tych leków. Działania te różnią się intensywnością i mogą znacznie zakłócać przebieg terapii. Celem niniejszej pracy jest przedstawienie i omówienie tych efektów niepożądanych, ich etiologii oraz częstości występowania.
Materiał i metody: Przeprowadzono przegląd dostępnej literatury za pomocą baz danych PubMed oraz Google Scholar. Wykorzystano następujące frazy wyszukiwania: leki przeciwpsychotyczne, efekty niepożądane, kardiotoksyczność, arytmia, dla prac oryginalnych, przeglądowych oraz meta-analiz opublikowanych w okresie od 1992 do 2024 roku.
Dyskusja: Od długiego czasu powszechnie znana jest duża liczba działań niepożądanych powodowanych przez leki przeciwpsychotyczne, szczególnie tych o charakterze sercowo-naczyniowym. Należą do nich: hipotensja ortostatyczna, wydłużenie odstępu QT, migotanie przedsionków, zmiany częstości akcji serca, a także kardiotoksyczność obejmującą zapalenie mięśnia sercowego i kardiomiopatie. Korzystnie, najpoważniejsze powikłania spowodowane związane z tymi efektami są stosunkowo rzadkie. Choć działania niepożądane leków przeciwpsychotycznych pierwszej i drugiej generacji są dokładnie opisane, to potencjalne efekty uboczne leków przeciwpsychotycznych trzeciej generacji wciąż wymagają dalszych badań.
Wnioski: Sercowo-naczyniowe efekty niepożądane związane ze stosowaniem leków przeciwpsychotycznych mogą stanowić poważne wyzwanie dla opieki zdrowotnej, a nawet zagrozić życiu pacjentów. Niemniej jednak, świadomość możliwych reakcji niepożądanych nie powinna zniechęcać lekarzy do przepisywania tych farmaceutyków, a raczej motywować ich do pogłębienia swojej wiedzy na ich temat. W ten sposób możliwe będzie poprawienie opieki nad pacjentami oraz skuteczności leczenia
Risk factors in children with recurrent urinary tract infectionamong patients attending Al Zahra Teaching Hospital in Iraq
Get PDFUrinary tract infections (UTI) are considered one of the most common infections that occur in the pediatric age group, leading to very serious morbidity and mortality. The detection of risk factors for urinary tract infection helps in the management and prevention of the recurrence of the infection. This study attempts to review current information on UTIs and determine different risk factors in association. To study the risk factors that are associated with recurrent urinary tract infection in different age groups of childhood among children attending AL Zahra Teaching Hospital.A case-control study was conducted in AL Zahra Teaching Hospital during the period from October 1st, 2021, to July 30th, 2022. It included 76 children with highly suggestive histories, their examination, and results of the investigations (e.g. urine cultures), as well as 150 healthy children who were taken as controls. The controls were without a history of recurrent UTI and were similar to patients in age, sex and other risk factors that were mentioned in the study. A completed questionnaire was given to each child\u27s mother, and then the results were analyzed.The study showed that non educated mothers OR (3.2), vesicouetrerall reflux OR (3), uncircumcised male OR (2.94), female gender OR (2.7), age groups below than 6 years OR (2.4), low social class OR (2.1) and residency in rural area (OR 2.5) contributed to UTI issues.When compared to control groups, non educated mothers and vesicoureteral reflux were highly significant risk factors, and other risk factors such as female gender, uncircumcised male, age less than 6 years, low social class and rural area were significant for febrile recurrent urinary tract infection in children
Sternalis muscle, a rare anatomical variation with clinical implications
Get PDFThe sternalis muscle is a rare variant of the anterior chest wall musculature. Although its frequency in general population worldwide has been reported from 2% to 8%, its prevalence depends on regions and populations. The aim of this paper is to describe one of the first cases of sternalis muscle found in Central Europe. An anterior chest wall of 64-year-old white male was dissected during a regular anatomy class at Department of Human Anatomy. A right unilateral sternalis muscle was revealed and described.The unilateral sternalis muscle laid between the pectoral and the superficial thoracic fascia. The muscle was long and wide. In addition, it had a massive tendon. According to the Snosek et al. Classification, it was a “simple unilateral” type. This report presents another case of the sternalis muscle among humans. Although the sternalis muscle serves a minor role in body movement, its occurrence gives several clinical implications. The awareness of variability in the thoracic region is important during diagnostic and treatment processes or in surgical operation planning
A comparison of the potential of Clinical Trials Centers within both public and commercial trial facilities
Get PDFClinical trials are an integral part of the process of developing new drugs, diagnostic methods and medical devices. Clinical trials offer patients the chance to access alternative treatment methods, thereby improving their quality of life, and even achieving recovery. Additionally, clinical trials provide the opportunity for regular contact with a specialist doctor and easier access to diagnostics, ensuring a faster therapeutic path for the patient. One of the key aspects of conducting clinical trials is choosing the right investigator and research center so as to meet specific criteria and guarantee high quality of the conducted studies. Therefore, the aim of the current study was to evaluate the differences between conducting clinical trials in public and commercial centers. A diagnostic survey was used in the study and the research tool chosen was a proprietary questionnaire belonging to the research technique as survey questionnaire. Questionnaires were constructed for the appropriate stakeholders/respondents, namely: doctors and employees of pharmaceutical companies and CROs. The analysis showed that employees of pharmaceutical companies, given the choice, prefer to cooperate with commercial centers. They choose public centers only when they need a center for phase one trials or those requiring hospitalization. The research obtained shows that public centers should improve administrative processes in order to optimize tasks such as contracting or obtaining a study
The incidence of oral dryness in people over 65 years living in Lublin
Get PDFSaliva plays an important part in naturally maintaining oral homeostasis. Dry mouth or \u27xerostomia\u27, is a serious problem connected with decreased saliva secretion which considerably limits the quality of life in elderly people. The aim of the study was the assessment of the subjective oral dryness in the oral mucosa in people over 65 living in Lublin, Poland. The study was conducted among 240 people aged 65 to 96. The patients were placed into two groups: I - 117 residents of nursing homes, II - 123 people living with their families. Assessment of the subjective oral dryness taking into account the place of residence, sex and drug administration was performed based on a questionnaire survey. In the group of nursing homes residents, 32.48% of the surveyed experienced subjective oral dryness, while among the seniors living with their families, 33.33% reported this kind of discomfort. The conducted analysis revealed that oral dryness was more common amongst women than men, and it can be very often a side-effect of administered medicine drugs
Ocena psychometryczna polskiej wersji Kwestionariusza postaw pracowników ochrony zdrowia wobec zgłaszania klinicznych zdarzeń niepożądanych (P-RoCAES)
Get PDFABSTRACT PSYCHOMETRIC EVALUATION OF THE POLISH VERSION OF THE QUESTIONNAIRE OF ATTITUDES OF HEALTHCARE WORKERS TOWARDS REPORTING OF CLINICAL ADVERSE EVENTS (P-ROCAES)
Aim. The purpose of the study was psychometric evaluation of the Polish version of the Questionnaire of Attitudes of Healthcare Workers towards Reporting of Clinical Adverse Events (P-RoCAES), based on an adaptation of the Reporting of Clinical Adverse Events Scale (RoCAES) by Wilson B., Bekker H.L., Fylan F.
Material and methods. A total of 101 participants took part in the study, 41.4% of whom were internal medicine nurses, the remaining percentage were nursing students. In addition to the P-RoCAES, the Author’s Survey Questionnaire, the Justice Sensitivity Inventory, the Moral Feelings Scale, the Perceived Stress at Work Scale were used.
Results. P-RoCAES reliability (internal consistency: Cronbach’s alpha 0.82; McDonald’s omega 0.80) and theoretical relevance for questions from the Author’s Survey Questionnaire were found. Convergent relevance with sensitivity to justice, feelings in moral situations, work stress perception were not proven. Confi rmatory factor analysis did not provide a reinforcement of the 5-dimensional factor structure of the original RoCAES.
Conclusions. The P-RoCAES achieved satisfactory psychometric properties in validation to Polish conditions, enabling to be used in research of attitudes towards adverse events among medical professionals and students, in order to educate and promote reporting culture for maintaining patient safety in healthcare. Despite possible limitations, the P-RoCAES should be considered an objective, valid, reliable tool.OCENA PSYCHOMETRYCZNA POLSKIEJ WERSJI KWESTIONARIUSZA POSTAW PRACOWNIKÓW OCHRONY ZDROWIA WOBEC ZGŁASZANIA KLINICZNYCH ZDARZEń NIEPOŻĄDANYCH (P-ROCAES)
Cel pracy. Celem badania była ocena psychometryczna polskiej wersji Kwestionariusza postaw pracowników ochrony zdrowia wobec zgłaszania klinicznych zdarzeń niepożądanych (P-RoCAES), dokonana w oparciu o adaptację kwestionariusza Reporting of Clinical Adverse Events Scale (RoCAES), autorstwa Wilson B., Bekker H.L., Fylan F.
Materiał i metody. W badaniu wzięło udział 101 osób, z czego 41,4% stanowiły pielęgniarki oddziałów internistycznych, a pozostały odsetek studenci pielęgniarstwa. W badaniu oprócz P-RoCAES wykorzystano również Kwestionariusz ankiety autorskiej, Skalę wrażliwości na sprawiedliwość, Skalę uczuć moralnych, Skalę postrzeganego stresu w pracy.
Wyniki. Stwierdzono rzetelność P-RoCAES (spójność wewnętrzna: Alfa Cronbacha 0,82; Omega McDonalda 0,80) oraz jego trafność teoretyczną w odniesieniu do pytań z Kwestionariusza ankiety autorskiej. Nie dowiedziono trafności zbieżnej z wrażliwością na sprawiedliwość, uczuciami w sytuacjach moralnych, postrzeganiem stresu w pracy. Konfi rmacyjna analiza czynnikowa (CFA) nie dostarczyła umocnienia założenia, że oryginalna RoCAES ma mieć 5-wymiarową strukturę czynnikową.
Wnioski. P-RoCAES osiągnął zadowalające właściwości psychometryczne w procesie walidacji do warunków polskich, uprawniające go do zastosowania w praktyce, w badaniach naukowych postaw wobec zdarzeń niepożądanych, wśród profesjonalistów opieki zdrowotnej i studentów kierunków medycznych, w celu edukacji i promowania kultury raportowania dla zachowania bezpieczeństwa pacjenta w opiece zdrowotnej. Pomimo możliwych ograniczeń, należy P-RoCAES uznać za obiektywne, ważne i niezawodne narzędzie
Potrzeby pacjentów, wymagania funkcjonalne, preferencje estetyczne i bariery w terapii opartej na aplikacjach w przypadku choroby zwyrodnieniowej stawu kolanowego
Get PDFPATIENT NEEDS, FUNCTIONAL REQUIREMENTS, AESTHETIC PREFERENCES AND BARRIERS IN APP-BASED THERAPY FOR KNEE OSTEOARTHRITIS
Introduction. Knee osteoarthritis (KOA) is an infl ammatory condition aff ecting over 25% of adults. Web/mobile technology off ers potential benefi ts in the treatment of KOA by improving access to care and reducing costs by utilising mobile devices for medical care and patient education.
Aim. The study aims to answer the question of what needs, functional requirements and aesthetic preferences patients with knee osteoarthritis have and what barriers and facilitators there are when using an app-based therapy.
Material and methods. We used a qualitative research design with in-depth interviews with 20 patients.
Results and conclusion. Interviewees emphasized that effective KOA management apps must address diverse patient needs, ensure accessibility, offer customizable features, provide comprehensive information and self-management tools, support pain relief, enable remote monitoring, integrate with support communities, and be cost-efficient. These apps should combine functional requirements, such as a simple user interface, integration with wearable devices, educational content, exercise guidance, pain management tools, remote consultations, community support, and feedback mechanisms, with aesthetic preferences for clear, accessible design, large fonts, high-contrast colours, suitable interactive elements, consistent layout, guiding animations, and accessibility features like text resizing, voice commands, and audio descriptions. In conclusion, this study underscores the necessity for KOA management apps to integrate diverse functional requirements and aesthetic preferences, ensuring accessibility, customization, comprehensive information, and support features to enhance usability, effectiveness, and patient satisfaction.POTRZEBY PACJENTÓW, WYMAGANIA FUNKCJONALNE, PREFERENCJE ESTETYCZNE I BARIERY W TERAPII OPARTEJ NA APLIKACJACH W PRZYPADKU CHOROBY ZWYRODNIENIOWEJ STAWU KOLANOWEGO
Wprowadzenie. Choroba zwyrodnieniowa stawu kolanowego (KOA) to stan zapalny, na który cierpi ponad 25% dorosłych. Technologia internetowa/mobilna oferuje potencjalne korzyści w leczeniu KOA, poprawiając dostęp do opieki i obniżając koszty poprzez wykorzystanie urządzeń mobilnych w opiece medycznej i edukacji pacjentów.
Cel pracy. Celem badania jest odpowiedź na pytanie, jakie potrzeby, wymagania funkcjonalne i preferencje estetyczne mają pacjenci z chorobą zwyrodnieniową stawu kolanowego oraz jakie bariery i ułatwienia napotykają podczas korzystania z terapii opartej na aplikacji.
Materiał i metody. Zastosowaliśmy jakościowy projekt badawczy obejmujący wywiady pogłębione z 20 pacjentami.
Wyniki. Rzetelność skali upadków Morse’a mierzona współczynnikiem alfa Cronbacha wyniosła 0,484. Stosując punkt odcięcia 35, czułość wynosiła 61,1%, a swoistość 53%. Dodatnia wartość predykcyjna wynosiła 10,5%, a ujemna wartość predykcyjna 90,6%.
Wyniki i wnioski. Rozmówcy podkreślali, że skuteczne aplikacje do zarządzania KOA muszą odpowiadać różnorodnym potrzebom pacjentów, zapewniać dostępność, oferować konfigurowalne funkcje, zapewniać kompleksowe informacje i narzędzia do samodzielnego zarządzania, wspierać łagodzenie bólu, umożliwiać zdalne monitorowanie, integrować się ze społecznościami wsparcia i być opłacalne. Aplikacje te powinny łączyć wymagania funkcjonalne – takie jak prosty interfejs użytkownika, integracja z urządzeniami do noszenia, treści edukacyjne, wskazówki dotyczące ćwiczeń, narzędzia do leczenia bólu, zdalne konsultacje, wsparcie społeczności i mechanizmy informacji zwrotnej – z preferencjami estetycznymi w zakresie przejrzystego, przystępnego projektu i dużych czcionek, kolory o wysokim kontraście, odpowiednie elementy interaktywne, spójny układ, animacje prowadzące i funkcje ułatwień dostępu, takie jak zmiana rozmiaru tekstu, polecenia głosowe i opisy audio. Podsumowując, badanie to podkreśla konieczność integrowania przez aplikacje do zarządzania KOA różnorodnych wymagań funkcjonalnych i preferencji estetycznych, zapewniania dostępności, dostosowywania, kompleksowych informacji i funkcji wsparcia w celu zwiększenia użyteczności, skuteczności i zadowolenia pacjentów
The effect of ethyl acetate extract from Atractylis flava Desf. on the gene expression of pro-inflammatory cytokines and oxidative stress markers in NR8383 alveolar rat macrophage cells
Get PDFAtractylis flava Desf. (AF) is common plant that is widely used for its anti- inflammatory and antioxidant properties. The purpose of this study was, therefore, to evaluate the cytotoxic effect and the molecular basis of antioxidant and anti-inflammatory effects of the ethyl acetate extract (AFEAE) obtained from the whole plant A. flava. This was accomplished through the use of NR8383 alveolar rat macrophage cells. Cultures of alveolar rat macrophage cells were treated with AFEAE (25–800 μg/mL), and cell viability was determined via WST-1 and LDH tests. In turn, the gene expression levels of nuclear factor κB (NF-κB), tumor necrosis factor-alpha (TNFα), interleukin 1 beta (IL1-β), interleukin 6 (IL-6), mitochondrial dynamin like GTPase (OPA1), Succinate dehydrogenase complex subunit A (SDHA) and neutrophil cytosolic factor 1 (NCF1) were assessed by applying RT-qPCR. The results show that ethyl acetate extracts of A. flava have non-cytotoxic effects, and the gene expression analysis demonstrates that AFEAF extracts generate significant downregulation of NF-κB, TNFα, IL-1 β, IL-6, NCF1, OPA1 and SDHA, compared to untreated cells. This study reveals that Atractylis flava ethyl acetate extract administration may be considered as a potential therapeutic strategy for inflammatory related diseases
Selected miRNAs in oropharyngeal squamous cell carcinoma (OPSCC) with HPV and EBV coinfection
Get PDFDifferent levels of miR-625-5p, miR-31-5p and miR-5100 have been reported in many cancers. Viral infections have been linked to miRNA levels in tumors, including those in the head and neck, but a large proportion of studies only include infections with a single virus. The aim of the present study is to assess the level of miR-625-5p, 31-5p and 5100 in oropharyngeal cancer with single HPV and EBV infections and HPV/EBV co-infection. The study examined 128 oropharyngeal cancer patients infected with EBV and HPV alone or co-infected with both viruses. For the determination of miRNAs, the enzyme immunoassays was used. Both miR-625-5p and miR-31-5p were higher in the HPV/EBV co-infection than in the single infection HPV or EBV. However, in the case of miR-5100, the values in co-infection were lower than in a single EBV infection. The analysis of miRNAs in relation to the histological grade and tumor classification, nodes (TN) showed that in poorly differentiated tumors the level of the studied miRNAs was higher compared to well-differentiated lesions, and in cases with larger tumor sizes and lymph node involvement, the miRNA values were both higher in single infections and co-infections
Changes in pharmaceutical prescription authorizationsand their impact on the number of prescriptions issuedby pharmacists in Poland
No full textThe Pharmaceutical Law Act of September 6, 2001 (PLA) initially granted pharmacists the authority to issue pharmaceutical prescriptions upon its enactment. However, the legislation regulating this matter changed significantly in 2015. Article 96, section 4 of the PLA defined that, in the front of a direct health threat to a patient, a pharmacist could dispense a medication classified under the availability categories Rp or Rpz. In April 2020, the imprecise term “sudden” in relation to health threats was clarified and removed. Concurrently, all active pharmacists were granted the authority to issue prescriptions, commonly known as pro auctore and pro familiae. The aim of the study was to illustrate the influence of legislative processes on the number of prescriptions issued by practicing pharmacists. To conduct the study, we employed a legal and comparative analysis of relevant legal provisions, followed by a statistical analysis of data obtained from the E-Health Center about the number of prescriptions issued. The results indicated that since the extension of pharmacists\u27 rights (after April 2020), the average number of pharmaceutical prescriptions issued per month was 151,082. Between May 2020, when pharmacists were granted the authority to issue pro auctore and pro familiae prescriptions, and October 2023, 1,460,385 such prescriptions were dispensed. As a result, a significant relationship between the form of the legislative norms empowering pharmacists to independently prescribe Rx status medicines and the effectiveness of these amendments as measured by the number of prescriptions issued was demonstrated