As the outcome of COVID-19 is associated with oxidative stress, it is highly probable that polymorphisms of genes related to oxidative stress were associated with susceptibility and severity of COVID-19. The aim of the study was to assess the association of glutathione S-transferases (GSTs) gene polymorphisms with COVID-19 severity in previously vaccinated and unvaccinated Polish patients with confirmed SARS-CoV-2 infection. A total of 92 not vaccinated and 84 vaccinated patients hospitalized due to COVID-19 were included. The WHO COVID-19 Clinical Progression Scale was used to assess COVID-19 severity. GSTs genetic polymorphisms were assessed by appropriate PCR methods. Univariable and multivariable analyses were performed, including logistic regression analysis. GSTP1 Ile/Val genotype was found to be associated with a higher risk of developing a severe form of the disease in the population of vaccinated patients with COVID-19 (OR: 2.75; p = 0.0398). No significant association was observed for any of the assessed GST genotypes with COVID-19 disease severity in unvaccinated patients with COVID-19. In this group of patients, BMI > 25 and serum glucose level > 99 mg% statistically significantly increased the odds towards more severe COVID-19. Our results may contribute to further understanding of risk factors of severe COVID-19 and selecting patients in need of strategies focusing on oxidative stress.

According to the Polish law, each patient has the right to refuse to consent to a medical procedure, even if the refusal concerns a life-saving procedure. It may be difficult for a physician to accept this kind of decision. In each case, however, medical intervention requires patient’s consent. Its lack makes physician’s actions illegal. Such a situation becomes more complicated when the patient who is intellectually incompetent, unconscious or illiterate is unable to express a consent to a medical procedure. Then, the possibility and the need to document and prove the patient’s consent becomes crucial from the point of view of the legality of medical personnel’s conduct. In this article, two representative clinical cases are discussed in the context of the legal assessment of the physician’s conduct in the event of legal complications related to the process of consenting to medical treatment. The authors analyze ethical dilemmas and legal risks that doctors may face in the process of consenting to risky medical procedures by unconscious and illiterate patient.

Background: The NOS2 gene polymorphism rs2297518 is associated with an increased level of NO, which could contribute to colorectal cancer (CRC) development. We hypothesized that the potential influence of the NOS2 gene polymorphism on cancer development may vary between right-sided and left-sided colon cancers, and rectal cancers. The aim of this study was to determine the rs2297518 polymorphism influence on colorectal cancer development with regard to tumor localization. Methods: This case–control study included 199 patients with CRC and 120 controls. The qPCR endpoint genotyping was conducted using the TaqMan^® genotyping assay. Results: This study revealed significant differences in tumor characteristic and in the minor alelle A frequency in the NOS2 genotype between colorectal cancers with different localizations. The mucinous adenocarcinoma was diagnosed significantly more often in right-sided cancers than in left-sided (30.6% vs. 10.9%, p = 0.009) and rectal cancers (30.6% vs. 7.1%, p = 0.0003). The minor allele A of the NOS2 genotype was observed more frequently in right-sided cancers than in left-sided cancers (44.9% vs. 23.1%, p = 0.0137) and more frequently in rectal cancers than in left-sided cancers (40.0% vs. 23.1%, p = 0.0285). Conclusions: In conclusion, the results support the hypothesis that the SNP rs2297518 of the NOS2 gene influences colorectal cancer development with regard to tumor localization.

The profession of psycho-oncologist in Poland is not sufficiently regulated by law. The issue is further complicated by the fact that this profession has not been classified by the legislature in the group of medical professions, but only in the group of allied health professions. Currently,...

Background: Colorectal cancer (CRC), the most common malignancy of the gastrointestinal tract, is the second leading cause of cancer-related deaths worldwide. In this context, investigating low-penetrance gene variants associated with the increased risk of CRC represents a novel and crucial approach to enhancing prevention strategies and clinical surveillance. By focusing on these genetic variants, there is potential for more accurate prediction of individual CRC risk, which could contribute to the refinement of current screening and prophylactic programs. The aim of this case–control study was to explore the association between SIRT1 polymorphisms and CRC risk. Methods: We analyzed three SNPs—rs12778366 (T/C), rs3758391 (C/T), and rs7895833 (A/G)—in the promoter region of the SIRT1 gene, which may influence SIRT1 expression and thus play a role in cancer development. Our study included 200 patients with colorectal adenocarcinoma and 115 controls. Genomic DNA was extracted from blood samples, and SIRT1 SNP analysis was performed using the qPCR method and endpoint genotyping. Results: Univariate regression analysis revealed a slightly increased risk of developing CRC in individuals with minor alleles of the analyzed polymorphisms; however, the observed differences were not statistically significant. Conclusions: Although our findings did not reveal statistically significant differences in SIRT1 gene polymorphism frequencies between the CRC group and the control group, we observed a tendency that suggests further investigation in larger cohorts is warranted. This research underscores the importance of understanding low-penetrance genetic factors in CRC, highlighting their potential to inform more personalized and effective prevention strategies.

Celem niniejszej pracy oryginalnej jest zaprezentowanie rozbieżności w stosowaniu przepisów prawa na tle obowiązku uzyskania zgody na podjęcie leczenia przez osobę, wobec której wydano postanowienie sądu zawierające zobowiązanie w tym zakresie. W oparciu o dane za lata 2010-2020, pozyskane ze specjalistycznego podmiotu leczniczego w rodzaju opieka psychiatryczna i leczenie uzależnień, dokonano analizy przypadków zastosowanego wobec pacjentów tego szpitala trybów leczenia odwykowego. Ocenie poddano informacje na temat liczby pacjentów leczących się odwykowo w tym okresie w tym podmiocie leczniczym, porównując liczbę leczonych w oparciu o ich własną zgodę oraz skierowanych do leczenia na mocy postanowienia sądu. We wszystkich przypadkach, które oznaczono jako "zrealizowane" poprzez przymusowe doprowadzenie do szpitala, a których liczba wynosi w poszczególnych latach, odpowiednio: 2016 - 407, 2017 - 416, 2018 - 379, 2019 - 412 a w 2020 - 364, zwolnienie pacjenta ze szpitala po zakończonym leczeniu następowało dopiero w oparciu o postanowienie sądu a nie na podstawie jego zgody własnej - wypisu na żądanie. Powyższa analiza wskazuje zatem, że na przestrzeni 5 lat pacjenci w liczbie 1978 nie mogli opuścić szpitala do momentu wydania przez sąd w tej materii stosownego postanowienia. Mając na względzie rezultaty wykładni literalnej oraz systemowej przepisów, które regulują zasady wyrażania zgody na czynności medyczne, należy przyjąć, że prawna możliwość egzekwowania nałożonego przez sąd obowiązku leczenia odwykowego po stwierdzeniu w prawem przepisanym trybie, iż zachodzą medyczne oraz społeczne przesłanki jego orzeczenia, może prawnie oraz faktycznie dotyczyć jedynie etapu przyjęcia do stacjonarnego lub niestacjonarnego zakładu leczenia odwykowego.