Acute kidney injury (AKI) is a global health challenge of vast proportions, as approx. 13.3% of people worldwide are affected annually. The pathophysiology of AKI is very complex, but its main causes ...are sepsis, ischemia, and nephrotoxicity. Nephrotoxicity is mainly associated with the use of drugs. Drug-induced AKI accounts for 19–26% of all hospitalized cases. Drug-induced nephrotoxicity develops according to one of the three mechanisms: (1) proximal tubular injury and acute tubular necrosis (ATN) (a dose-dependent mechanism), where the cause is related to apical contact with drugs or their metabolites, the transport of drugs and their metabolites from the apical surface, and the secretion of drugs from the basolateral surface into the tubular lumen; (2) tubular obstruction by crystals or casts containing drugs and their metabolites (a dose-dependent mechanism); (3) interstitial nephritis induced by drugs and their metabolites (a dose-independent mechanism). In this article, the mechanisms of the individual types of injury will be described. Specific groups of drugs will be linked to specific injuries. Additionally, the risk factors for the development of AKI and the methods for preventing and/or treating the condition will be discussed.
The necessity of providing healthcare to citizens is one of the basic principles of every state, regulated by provisions of national, EU or international law and complemented by soft law. ...Civilisational changes and technological advancement make it possible to develop new healthcare tools and services (i.a. telemonitoring, teleconsulting, telerehabilitation and electronic medical documentation). The COVID-19 pandemic greatly emphasised the need to provide such services. The wide use of e-health, however, which may be a remedy for numerous problems that the healthcare sector is wrestling with, requires securing the rights of those who are not digitally included, especially the elderly. The prevalence of various degrees of digital exclusion, not only among the elderly, makes these issues socially significant and they should be solved by law. The purpose of the article is an initial analysis of the validity of developing e-health services in the ageing society in Poland and a presentation of proposals for adjusting legal solutions as regards the use of digital tools in healthcare to the changing reality.
Cel naukowy: Przedstawienie możliwości wykorzystywania funkcjonalności e-recept w Polsce w perspektywie uwarunkowań społecznych, demograficznych i technicznych oraz wskazanie koniecznych zmian w tym ...zakresie.
Problem i metody badawcze: W celu przeanalizowania, czy w świetle uwarunkowań prawnych i społecznych e-recepty mogą przynosić świadczeniobiorcom dodatkowe – w porównaniu do papierowych recept – korzyści, przeanalizowano dane statystyczne i regulacje prawne, wykorzystując metodę logiczno-językową.
Proces wywodu: Na kanwie postępującej cyfryzacji i procesu starzenia się społeczeństw przedstawiono poziom e-wykluczenia, ze szczególnym uwzględnieniem seniorów. Scharakteryzowano funkcjonowanie Internetowego Konta Pacjenta (IKP) i e-recepty oraz wskazano na konieczne do wprowadzenia zmiany, tak aby funkcjonalność e-recepty nie zależała od poziomu kompetencji cyfrowych świadczeniobiorców.
Wyniki analizy naukowej: Wśród seniorów w Polsce wykluczenie cyfrowe wynosi blisko 57%. Odsetek posiadających aktywną aplikację IKP jest niewielki, szczególnie wśród osób starszych. Tym samym dla większości pacjentów e-recepta sprowadza się do posiadania wydruku informacyjnego o e-recepcie lub 4-cyfrowego kodu.
Wnioski, innowacje, rekomendacje: W związku z wysokim poziomem e-wykluczenia, szczególnie w populacji osób starszych, konieczne jest implementowanie, wraz z rozwiązaniami cyfrowymi, rozwiązań prawnych umożliwiających pełne korzystanie z usług zdrowotnych także osobom nieposługującym się nowoczesnymi technologiami. Rozwiązaniem takim mogłoby być wprowadzenie obowiązku etykietowania leków wydawanych w aptece, tak aby do informacji dotyczących recepty i leku, które aktywny użytkownik IKP znajduje na swoim koncie, dostęp mieli także e-wykluczeni.
Urinary tract infections (UTI) represent one of the most common contagious diseases in humans. Uropathogenic Escherichia coli (UPEC) strains are recognized as the most frequent causative agent, and ...these express a range of virulence factors including the adhesins. Immune response to UPEC under immunosuppression has not been fully understood yet. Interleukin 1β (IL1β), 6 (IL6) and 17 (IL17) represent clinically relevant markers of inflammation.
The study aimed to investigate the interplay between UPEC genotype and hosts' immune status in shaping local inflammatory response in the course of an UTI episode. The respective numbers of: 18 kidney recipients with UPEC UTI, 28 immunocompetent hosts with UPEC UTI and 29 healthy controls were involved. Urine IL1β, IL6, and IL17/creatinine ratios in relation to fimH, csgA, papC, tosA, and flu genes presence in UPEC isolated from the urine samples were analyzed. Apart from traditional statistics, also machine learning algorithms were applied.
The urine levels of IL1β and IL 6 were similar in kidney recipients and the immunocompetent hosts. IL1β levels were higher in both kidney recipients and immunocompetent hosts than in controls, while IL6 levels were higher only in immunocompetent hosts than in controls. In the machine learning classification model, high urine IL17 levels were significantly more prevalent in controls, while low IL17 levels in urines infected with Ag43-positive UPEC strains, regardless of the host's immune status. In the traditional statistical analysis, IL17 levels appeared significantly higher in urine samples from kidney recipients infected with Ag43-negative UPEC strains.
In the UTI- affected patients, the combination of the immune status of an individual and Ag43 status of the UPEC strain determined urine IL17 level in the analyzed group. However, IL17 levels above median were overall more prevalent in controls.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
A sole proprietorship is the most common form of running a business. The numberof enterprises operated in Poland has been growing dynamically for over 30 years.At the same time, the population of ...Poland is the fastest ageing society in the EU.In the light of the above, many enterprises may soon face the problem of maintainingbusiness continuity in the event of death of their owners. The article attemptsto evaluate the implementation of the institution of succession management ofa natural person’s enterprise into the Polish legal framework one year after newsolutions were offered to Polish entrepreneurs. To this end, the way how entrepreneursmake use of this institution has been analysed.
System Vicarious Calibration (SVC) ensures a relative radiometric calibration to satellite ocean color sensors that minimizes uncertainties in the water-leaving radiance Lw derived from the top of ...atmosphere radiance LT. This is achieved through the application of gain-factors, g-factors, to pre-launch absolute radiometric calibration coefficients of the satellite sensor corrected for temporal changes in radiometric sensitivity. The g-factors are determined by the ratio of simulated to measured spectral LT values where the former are computed using: i. highly accurate in situ Lw reference measurements; and ii. the same atmospheric models and algorithms applied for the atmospheric correction of satellite data. By analyzing basic relations between relative uncertainties of Lw and LT, and g-factors consistently determined for the same satellite mission using different in situ data sources, this work suggests that the creation of ocean color Climate Data Records (CDRs) should ideally rely on: i. one main long-term in situ calibration system (site and radiometry) established and sustained with the objective to maximize accuracy and precision over time of g-factors and thus minimize possible biases among satellite data products from different missions; and additionally ii. unique (i.e., standardized) atmospheric model and algorithms for atmospheric correction to maximize cross-mission consistency of data products at locations different from that supporting SVC. Finally, accounting for results from the study and elements already provided in literature, requirements and recommendations for SVC sites and field radiometric measurements are streamlined.
•System Vicarious Calibration (SVC) for satellite ocean color (OC) sensors.•Uncertainties in SVC correction factors supporting OC Climate Data Records (CDRs).•Recommendations for sites and in situ SVC measurements supporting OC CDRs.
Pandemia spowodowała zmiany w funkcjonowaniu społeczeństwa, nie omijając też wymiaru sprawiedliwości. Potrzeba zachowania dystansu społecznego przy-spieszyła zmiany w sądownictwie. Wprowadzono ...rozprawy zdalne. W artykule podjęto próbę odpowiedzi na pytanie, czy wobec występującego w społeczeństwie polskim zjawiska wykluczenia cyfrowego prowadzone obecnie e-rozprawy odbywają się w zgodzie z zasadą równości. Przeprowadzone przez studencką grupę badawczą badania empiryczne rozpraw zdalnych i własne doświadczenia autorki w tym zakresie składają się na materiał empiryczny wskazujący na występujące podczas rozpraw zdalnych problemy techniczne i te związane z wykluczeniem cyfrowym.
Jednoosobowa działalność gospodarcza jest najpopularniejszą formą prowadzenia działalności gospodarczej. Od ponad 30 lat obserwowany jest dynamiczny rozwój liczby przedsiębiorstw w Polsce. ...Jednocześnie Polacy są najszybciej starzejącym się społeczeństwem UE. W związku z powyższym w najbliższym czasie w wielu przedsiębiorstwach może wystąpić problem z zapewnieniem ciągłości funkcjonowania podmiotów gospodarczych w przypadku śmierci przedsiębiorców. W artykule podjęto próbę oceny implementacji instytucji zarządu sukcesyjnego przedsiębiorstwem osoby fizycznej do polskiego prawa w pierwszą rocznicę wprowadzenianowych rozwiązań dla przedsiębiorców. W tym celu dokonano analizy jej wykorzystania przez przedsiębiorców.
The pandemic has changed the way society functions, affecting the system of justice as well. The need to maintain social distance has accelerated changes in the judi-ciary. Remote hearings have ...emerged. The article attempts to answer the question of whether the e-hearings currently taking place are held in accordance with the principle of equality in view of the phenomenon of digital exclusion occurring in Polish society. An empirical study of remote hearings conducted by a student research group and the author’s own experience in this field make up the empirical resources documenting the technical issues that occur during remote hearings and problems related to digital exclusion.
This systematic review was conducted to gather evidence of preeclampsia occurring before the 20th week of gestation, additionally considering the role of PLGF and sFlt-1 in the development of the ...disease. In the three cases of preeclampsia before the 20th week of gestation presented in the authors' material, all pregnancies ended up with IUFD, and the SFlt-1/PLGF ratios were significantly elevated in all women. Eligible publications were identified with searches in the PubMed, Embase, Scopus, and Web of Science databases. No date or language restrictions were made. All original peer-reviewed scientific reports were included. A total of 30 publications were included in the final report, including case reports and case series. No other publication types regarding this issue were identified. In the literature, 34 cases of preeclampsia with onset occurring before the 20th week of gestation were identified, for a final total of 37 cases. Live births were reported in 5 cases (10.52%), and there were 9 intrauterine fetal demises (24.32%), and 23 terminations of pregnancy (62.16%). Preeclampsia before the 20th week of gestation is rare but can occur. We collected all available evidence regarding this phenomenon, with 37 cases reported worldwide. We call for large-scale cohort or register-based studies to establish revised definitions or develop new ones regarding the currently unrecognized very early onset preeclampsia.
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