Instytut Medycyny Wsi im. Witolda Chodźki

The aim of the article is to provide a systematic analysis of the legal framework and various forms of responsibility of the manager of a healthcare facility in Poland in the context of patient rights. It emphasises that effective management in this area is not only a matter of compliance with the law, but is also a fundamental factor determining the health outcomes of the population. The study is based on interdisciplinary methodology integrating legal analysis, public health, and healthcare management. Sources included legal acts, case law, and scholarly literature from databases such as PubMed and Google Scholar, selected through key word searches. Methods of analysis and synthesis, deduction and induction, and critical analysis of factual and legal contexts were employed. The study also includes participant observation from the authors' experience, enabling comparison of legal norms with healthcare practice and international approaches. The analysis reveals that healthcare facility managers bear diverse legal responsibilities (civil, criminal, and disciplinary) arising from key regulations, such as the Act on Patients' Rights and the Patient Ombudsman and the Act on Medical Activity. Organizational culture, internal policy, and teamwork fundamentally influence patient rights, safety, and positive patient experiences, which are crucial for public health. The crucial supervisory role of the Patient Ombudsman is also emphasized. Effective management implemented by healthcare facility managers, based on a thorough understanding of patient rights and their systemic responsibilities, is crucial for creating a high-quality, safe and patient-centred healthcare environment. This directly contributes to improved public health and increased resilience of the healthcare system.

Objective.Integration of cerebral blood macrocirculation and microcirculation form a crucial aspect of global cerebral blood flow. Our study aimed to investigate time delay between pulse oscillations of cerebral blood flow velocity (FV) and total hemoglobin concentration (tHb) acquired via transcranial Doppler ultrasonography and functional near-infrared spectroscopy, respectively. Additionally, we compared time-related characteristics with cerebral arterial time constant (τ).Approach.The study involved monitoring of FV, tHb, arterial blood pressure and end-tidal CO2(EtCO2) during 5 min of rest (normocapnia) and 5 min of controlled hypercapnia in 36 healthy subjects (age: 24 years,Q1-Q3: 21-27 years, 15 females). Onset time delay (onset TD) was defined as the time offset between onsets of FV and tHb pulses, and time to tHb max (TTM) as a time difference between the FV pulse onset and tHb pulse maximum.τwas calculated as a product of cerebrovascular compliance and resistance. Onset TD and TTM were compared between normocapnia and hypercapnia, and their associations withτwere assessed.Main results.Onset TD was consistently positive (0.075 s,Q1-Q3: 0.065-0.108 s). Onset TD andτwere significantly shorter in hypercapnia (0.075 s vs 0.071 s,p< 0.001; 0.107 s vs 0.099 s,p< 0.001). Changes in onset TD andτbetween normo- and hypercapnia were significantly correlated (RS= 0.452,p< 0.01). TTM was correlated withτin normocapnia (RS= 0.364,p= 0.03), hypercapnia (RS= 0.407,p= 0.01) and in terms of relative changes (RS= 0.421,p= 0.01).Significance.There is a time delay between cerebral macro- and microcirculation, which becomes shorter as the cerebral vasculature dilates in hypercapnia.

IntroductionBartonella spp. are gram-negative, facultative intracellular bacteria with zoonotic potential. These microorganisms are emerging vector-borne pathogens distributed worldwide and infecting humans, domestic mammals and wildlife. This study investigated the possibility of culturing Bartonella henselae in a tick cell line derived from Ixodes ricinus.Material and MethodsThe Ixodes ricinus embryonic cell line (IRE/CTVM19) and the Houston-1 strain of B. henselae were used for culture studies. Replication of B. henselae was quantified with the use of a SYBR Green real-time PCR and transcribed complementary DNA (cDNA) in samples collected separately from the supernatant and monolayer of culture from 1 to 9 days post-infection (d.p.i.). Identification of B. henselae was based on the detection of a fragment of the ribC gene encoding riboflavin synthase. Quantification was performed indirectly by determining the threshold cycle.ResultsMicroscopic observations confirmed that infection with B. henselae did not show any visible negative effect on tick cells. The quantity of B. henselae cDNA from the monolayer remained low, and a slight increase was observed at 4, 8 and 9 d.p.i. Significantly, the highest amount of B. henselae was observed at 2 d.p.i. in samples isolated from the supernatant.ConclusionThe maintenance of live B. henselae in an I. ricinus-derived cell line was confirmed. The low level of multiplication in the tick cell line suggested a limited role of I. ricinus as a reservoir of B. henselae. The IRE/CTVM19 tick cell line is suitable for culture of B. henselae, and this model may be useful in further studies.

IntroductionGiardia duodenalis is the prevalent parasitic protozoan responsible for diarrhoeal disease in humans and animals. This study aimed to determine the prevalence and assemblages of this parasite present in cattle in Poland.Material and MethodsFaecal samples were collected from 1,602 cattle up to 4 months old, bred on 267 farms located in all 16 voivodeships of Poland. Extraction of DNA was performed using a modified alkaline and a heat lysis method. Molecular detection of β-giardin gene by PCR and sequence analysis were performed.ResultsIn 174 of 1,602 (10.9%) tested cattle and in 89 of 267 examined herds (33.3%), G. duodenalis DNA was detected. The highest prevalence of Giardia in cattle was found in the Lubelskie (25%), Mazowieckie (21.3%) and Zachodniopomorskie (20.4%) voivodeships. In other regions, the prevalence did not exceed 10%. The number of Giardia-positive cattle decreased with animal age. The most frequently identified assemblage in cattle was E (89.2%), and A and B were detected more seldom in 9.0% and 1.8% of cattle, respectively. No significant differences in positive results were observed in cattle depending on production purpose.ConclusionThe study results showed a high prevalence of Giardia in cattle in Poland. The presence of the Giardia A and B assemblages indicates a potential zoonotic threat.

The recognition of amine groups by ninhydrin, along with a simple mathematical algorithm, showed that di- and tripeptides derived from dietary protein are the major end products of protein digestion entering the blood postprandially. There are thousands of oligopeptides appearing in the gut during protein digestion. However, the presented study on a pig model clearly shows that peptides longer than tri-amino acid peptides do not appear postprandially in the blood in nutritional amounts. We hypothesize that the measurement of postprandial free amino acids, di- and tripeptides and proportions between these components could be a useful, desirable tool both in laboratory and clinical practice, which could be used to determine the metabolic importance of protein digestion end products in health and disease.

Background: This study investigated the relationship between serum selenium concentration and metabolic markers-specifically lipid parameters and glycemic control indicators (fasting glucose, insulin, HbA1c, HOMA-IR)-in middle-aged women, considering age as a covariate. Methods: A total of 387 women aged 45-67 years participated. Serum levels of selenium, glucose, insulin, HbA1c, HDL, LDL, and triglycerides were measured. Multiple linear regression models were used to evaluate the predictive value of the serum selenium concentration compared to age in predicting lipid and glycemic markers. Results: Selenium concentration was significantly and positively associated with HDL cholesterol only. No significant relationships were found between selenium and glycemic markers or other lipid parameters. In contrast, age emerged as a consistent positive predictor of LDL cholesterol, fasting glucose, and HbA1c levels. Furthermore, exploratory analysis suggested that HbA1c may influence the relationship between selenium and HDL/LDL cholesterol, though no formal moderation analysis was performed. Conclusions: Although serum selenium concentrations were within the normal range, their predictive value was limited to HDL cholesterol. Age showed a stronger and more consistent association with key metabolic markers, highlighting its importance as a predictor of cardiometabolic health in middle-aged women.

Previous observations indicating a lower incidence of various types of cancer in beekeepers suggest that greater exposure to stings reduces the risk of cancer development. However, it is not known which of the active compounds of the bee venom (BV) may be responsible for the observed properties. The aim of this study is to evaluate the anti-glioblastoma effect of the main BV fractions. In addition, the effect of BV fractions on the activity of matrix metalloproteinases 2 and 9 (MMP-2 and MMP-9) was assessed. Commercially available BV was divided into three fractions containing one of the main BV components: apamin (fraction #1), phospholipase A2 (fraction #2), or melittin (fraction #3). The viability of glioblastoma lines (LN18 and LN229) compared to a physiological line (human MO3.13) was assessed using the MTT. MMP-2 and MMP-9 activity was assessed using gelatin zymography. Tissue inhibitors of metalloproteinases 1 and 2 (TIMP-1 and TIMP-2) levels in cell culture media were measured with the ELISA method. The fraction containing apamin did not show cytotoxic activity up to a concentration of 100 µg/mL. The fraction containing phospholipase A2 partially reduced the cells' viability at a concentration of 100 µg/mL. The greatest activity was demonstrated by the melittin-containing fraction which completely reduced the viability of glioma cells from a concentration of 2.5 μg/mL and inhibited the activity of the assessed metalloproteinases in a dose-dependent manner. After 72 h of incubation, the highest concentrations of TIMP-1 and TIMP-2 (approximately 150 ng/mL and 100 ng/mL, respectively) were observed in the LN229 line. In all tested lines, fraction #3, crude BV, and melittin reduced the secretion of both inhibitors into the medium in a dose-dependent manner. The melittin-containing fraction possessed anti-glioma properties in vitro, suggesting that melittin may be the main anticancer compound of BV.

We aimed to determine whether berbamine (BBM) would have an effect on retinyl acetate (RA)-induced cystometric and biochemical parameters, characteristic of bladder overactivity. BBM exhibits anti-inflammatory, anti-oxidant, and muscle-relaxant effects which could counteract pathophysiological mechanisms observed in overactive bladder (OAB) syndrome. The cohort of 60 rats was divided into 4 groups: I-control, II-RA group, III-BBM, and IV-group with the combination of RA + BBM. The cystometry, BBF, cardiovascular parameters and diuresis, the analysis of the cFos, and biochemical biomarker levels were analyzed 48 h after completion of BRB administration. The examined substance turned out to reverse the cystometric changes and c-Fos expression changes induced by RA when compared to the control group. There were no significant changes observed in the analyzed groups of animals MAP, HR, BBF, or UP. Importantly, BBM also turned out to reduce the level of OAB biomarkers present in urine (NGF, BDNF), urothelium (TRPV1, SNAP29, ATP, CGRP, or OCT-3), bladder detrusor muscle (VAChT, Rho kinase) as well as to reduce the exponents of oxidative stress (3-nitrotyrosine, malondialdehyde). The multifactorial explanation of the successful alleviation of the RA-induced detrusor overactivity makes the concept of incorporation of BBM in the OAB treatment promising for the future research.

Despite the close and clinically confirmed association between depression and overactive bladder, it remains unclear whether this affective disorder is a factor causing overactive bladder or whether overactive bladder is a specific symptom of psychosomatic disorders. This study examined the effects of repeated corticosterone administration on the occurrence of symptoms associated with depression and overactive bladder. Additionally, we examined whether administering TC-G 1008, an antidepressant that selectively activates the GPR39 receptor, could alleviate corticosterone-induced depression-like behavior and detrusor overactivity-related changes in cystometric measurements. We also explored its potential to reverse alterations in various biomarkers associated with both conditions in the serum, urinary bladder, and brain of female rats. The administration of corticosterone (20 mg/kg/day for 14 days) yielded anticipated results, including an increase in the duration of immobility during the forced swim test, alterations in parameters specific to bladder overactivity, a decrease in neurotrophins, and an elevation in pro-inflammatory cytokine levels. Treatment with TC-G 1008 (15 mg/kg/day) alleviated symptoms of both detrusor overactivity and depression, while also restoring the levels of biochemical and cystometric markers to normal ranges. Additionally, antidepressants based on GPR39 agonists could enhance the levels of kynurenic acid in the neuroprotective pathway. These results indicate that the GPR39 agonist receptor might be a promising future therapeutic approach for treating overactive bladder that occurs alongside depression.